Orthopädisch-unfallchirurgische Versorgung bis 2050

Petzold, Thomas; Haase, E.L.; Niethard, Fritz U.; Schmitt, J.

doi:10.1007/s00132-015-3176-y

Cited by 14 publications

(7 citation statements)

References 8 publications

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“…It also draws attention to the important problem of rapidly growing rates of PJI and its associated challenges, which will certainly affect the clinical care. In combination with an expected population decline due to further aging and lower birth rates in the upcoming decades, this raises the question, if an already financially strained healthcare system will be able to cover this demand in the future [44]. At the same time, it emphasizes the need for qualified surgeons and for future research to improve the reliability and survivorship of TKA [28, 31].…”

Section: Discussionmentioning

confidence: 99%

The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years

Klug

Gramlich

Rudert

et al. 2020

Knee Surg Sports Traumatol Arthrosc

203

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Purpose Total knee arthroplasty (TKA) rates have increased substantially in the recent decades worldwide, with Germany being one of the leading countries in the prevalence of TKA. The aim of this study was to provide an overview of treatment changes during the last decade and to project the expected burden of primary and revision TKA (rTKA) for the next 30 years. Methods Comprehensive nationwide data from Germany was used to quantify primary and revision TKA rates as a function of age and gender. Projections were performed with use of a Poisson regression models and a combination of exponential smoothing and autoregressive integrated moving average models on historical procedure rates in relation to official population projections from 2020 to 2050. Results The incidence rate of primary TKAs is projected to increase by around 43% to 299 per 100,000 inhabitants [95% CI 231-368], leading to a projected total number of 225,957 primary TKAs in 2050 (95% CI 178,804-276,442). This increase has been related to a growing number of TKA performed in male patients, with the highest increase modelled in patients between 50 and 65 years of age. At the same time, the annual total number of revision procedures is forecast to increase even more rapidly by almost 90%, accounting for 47,313 (95% CI 15,741-78,885; IR = 62.7 per 100,000, 95% CI 20.8-104.5) procedures by 2050. Those numbers are primarily associated with a rising number of rTKAs secondary to periprosthetic joint infection (PJI). Conclusions Using this country-specific forecast approach, a rising number of primary TKA and an even more rapidly growing number of rTKA, especially for PJI, has been projected until 2050, which will inevitably provide a huge challenge for the future health care system. As many other industrialized nations will face similar demographic and procedure-specific developments, these forecasts should be alarming for many health care systems worldwide and emphasize the tremendous need for an appropriate financial and human resource management in the future. Level of evidence Level III, prognostic study, economic and decision analysis.

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Section: Discussionmentioning

confidence: 99%

The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years

Klug

Gramlich

Rudert

et al. 2020

Knee Surg Sports Traumatol Arthrosc

203

View full text Add to dashboard Cite

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“…The effect was also confirmed by our data, in which 71% ( p = 0.0001) of transfers occurred outside of core working hours and had to be handled by the on-call surgical team. The resulting intensification of work during calls may lead to job dissatisfaction or even scarce resources in the affected hospitals [ 25 , 26 ]. Watson’s view echoes the sentiment of numerous orthopedic surgeons practicing at Level I trauma centers.…”

Section: Discussionmentioning

confidence: 99%

It is (not) always on Friday: inter-hospital patient transfers in orthopedic and trauma surgery

Roos,

Loy,

Ploeger

et al. 2023

Eur J Trauma Emerg Surg

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Background While inter-hospital transfers for patients who have suffered major trauma have been well investigated, patient flows for other injured patients, or cases with orthopedic complications, are rarely described. This study aims to analyze the affected collective and to show possible reasons, patterns, and pitfalls to optimize the process in future. Materials and methods In a prospective cohort study, all consecutive transfers to a Level I trauma center in Germany were documented and assessed. Patients suffering a major trauma were excluded. Data on the primary treating hospital, patient characteristics, and differences between emergency and elective surgery were analyzed. Results A total of 227 patients were included; 162 were injured, while 65 had suffered a complication after elective orthopedic surgery or had a complex orthopedic pathology. The most common diagnoses leading to transfer were pathologies of the extremities (n = 62), pathologies of the spine (n = 50), and infections (n = 18). The main reasons stated by the transferring hospitals were a lack of expertise (137 cases) and a lack of capacity (43 cases). There was a significantly higher rate of transfers due to trauma (n = 162) than for orthopedic patients (n = 65), p < 0.0001. Conclusion There is currently no structured procedure or algorithm for transferring patients in orthopedics and trauma surgery.

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“…Currently, Germany has a high density of hospitals, but they are generally too small and insufficiently equipped in terms of specialized personnel and modern technical equipment [ 3 , 4 ]. This situation leads to care-related transfers between hospitals and is expected to worsen further by 2030 due to the anticipated significant increase in the burden of orthopedic and trauma surgery-related diseases, combined with a lack of nursing staff and overall personnel scarcity [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Optimizing Interhospital Transfers in Orthopedics and Trauma Surgery: Challenges, Insights, and Proposals for Standardized Care in Germany

Roos,

Ben Amar,

Weinhold

et al. 2024

Clinics and Practice

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Background: Germany’s high density of under-equipped hospitals and anticipated surge in orthopedic and trauma surgery-related diseases by 2030, combined with personnel shortages, are expected to increase patient transfers between hospitals, an issue that urgently needs standardized protocols. Despite some existing cooperative agreements, such as between joint-replacement centers or within the Trauma Network DGU®, these measures do not adequately address the full range of patient-transfer cases, including those due to a lack of specialization or staff shortages, resulting in delayed treatment and potential health risks. This study aims to dissect the intricacies of interhospital transfers in orthopedics and trauma surgery across Germany, focusing on understanding the underlying reasons for transfers, comparing the operational structures of small and large hospitals, and laying the groundwork for future standardized protocols to enhance patient care. Material and Methods: A cross-sectional study was conducted in the form of an online survey via SoSci Survey, which was directed at orthopedic surgeons and trauma surgeons working in hospitals in Germany. The 22-question survey gathered information on participants’ clinic roles, departmental details, transfer processes, frequent diagnoses, perceptions of transfer quality, and improvement areas. The survey was sent to orthopedic and trauma surgeons in Germany by the specialist society. The data were analyzed using descriptive and inferential statistics to ensure a comprehensive insight into interhospital transfer practices. Results: The study involved 152 participants from various hospital ranks and located in different hospital sizes and types across rural and urban areas. A significant difference was observed between the care structures of basic/regular care and central/maximum care hospitals, especially regarding the available facilities and specialties. These findings suggest improvements such as better patient documentation, increased digital communication, optimized patient distribution, and standardization of transfer requests, among others. Conclusions: This study highlights the urgent need for improved protocols and resource allocation to eliminate inequalities in transfers between hospitals in orthopedics and trauma surgery in Germany.

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Orthopädisch-unfallchirurgische Versorgung bis 2050

Cited by 14 publications

References 8 publications

The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years

The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years

It is (not) always on Friday: inter-hospital patient transfers in orthopedic and trauma surgery

Optimizing Interhospital Transfers in Orthopedics and Trauma Surgery: Challenges, Insights, and Proposals for Standardized Care in Germany

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