Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study conducted at a German University Hospital

Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study... Introduction Hip fractures have increased medical and socio-economic importance due to demographic transition. Informa- tion concerning direct treatment costs and their reimbursement in Germany is lacking. Materials and methods Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimburse- ment. Finally, statistical analysis was performed to identify clinical parameters influencing the cost–reimbursement relation. Results Treatment costs were 8853 € (95% CI 8297–9410 €), while reimbursement was 8196 € (95% CI 7707–8772 €), resulting in a deficit of 657 € (95% CI 143–1117 €). Bivariate analysis showed that the cost–reimbursement relation was negatively influenced mainly by higher age, higher ASA score, readmission to the intensive care unit (ICU) and red blood cell transfusion. Adjusted for other parameters, readmission to the ICU was a significant negative predictor (− 2669 €; 95% CI – 4070 to − 1268 €; p < 0.001), while age of 60–75 years was a positive predictor for the cost–reimbursement relation (1373 €; 95% CI 265–2480 €; p = 0.015). Conclusions Treatment of geriatric hip fracture patients in a university hospital in Germany does not seem to be cost- covering. Adjustment of the reimbursement for http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Orthopaedic and Trauma Surgery Springer Journals

Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study conducted at a German University Hospital

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2017 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Orthopedics
ISSN
0936-8051
eISSN
1434-3916
D.O.I.
10.1007/s00402-017-2844-2
Publisher site
See Article on Publisher Site

Abstract

Introduction Hip fractures have increased medical and socio-economic importance due to demographic transition. Informa- tion concerning direct treatment costs and their reimbursement in Germany is lacking. Materials and methods Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimburse- ment. Finally, statistical analysis was performed to identify clinical parameters influencing the cost–reimbursement relation. Results Treatment costs were 8853 € (95% CI 8297–9410 €), while reimbursement was 8196 € (95% CI 7707–8772 €), resulting in a deficit of 657 € (95% CI 143–1117 €). Bivariate analysis showed that the cost–reimbursement relation was negatively influenced mainly by higher age, higher ASA score, readmission to the intensive care unit (ICU) and red blood cell transfusion. Adjusted for other parameters, readmission to the ICU was a significant negative predictor (− 2669 €; 95% CI – 4070 to − 1268 €; p < 0.001), while age of 60–75 years was a positive predictor for the cost–reimbursement relation (1373 €; 95% CI 265–2480 €; p = 0.015). Conclusions Treatment of geriatric hip fracture patients in a university hospital in Germany does not seem to be cost- covering. Adjustment of the reimbursement for

Journal

Archives of Orthopaedic and Trauma SurgerySpringer Journals

Published: Dec 2, 2017

References

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