Unfallchirurgisch-geriatrisches Co-Management in der Alterstraumatologie

Bücking, Benjamin; Liener, U. C.; Bliemel, Christopher; Ruchholtz, Steffen

doi:10.1055/s-0043-118309

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…On the other hand, elderly patients often take longer to recover from a fall and mTBI. Disruption of their daily routine and even short-term confinement to bed can lead to decompensation of their often already fragile socio-medical condition and make it difficult to return them to their home environment [ 7 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the advanced age at the time of trauma, indirect medical costs such as incapacity to work are lower in geriatric trauma patients compared to younger ones. However, longer hospitalizations, more complex treatments, later need for care and recurrent falls make the care of this patient group resource-intensive and poses a social, medical and health economic challenge [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Health Economic Challenge: Geriatric Trauma—An Age-Based Observational Analysis of Treatment Costs and Reimbursement Issues

Schindler

Woschek

Mühlenfeld

et al. 2022

IJERPH

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Demographic change is having a major impact on the economic and structural development of the healthcare system. People stay active longer and the number of mild traumatic brain injury [mTBI] in patients ≥ 65 years of age consequently increases. The aim of this comparative analysis is to illustrate the impact of demographic change and the increasing treatment of geriatric trauma patients on the cost structure of the health care system using mTBI as an example diagnosis. Patients and Methods: The 12-month retrospective analysis included 220 in-patients treated with mTBI and remunerated under the German Diagnosis Related Group [G-DRG] B80Z. For comparative analysis, the patient population was divided into two study groups according to age [U65 18–64 years, G65 ≥ 65 years]. For the cost and proceeds calculation, itemized cost reports (personnel, supply, material, and equipment costs, etc.) were created. Results: 163 patients U65 and 57 patients G65 were included. In the G65 group, the most frequent accident mechanism was a fall from a short distance (84.1 vs. U65 36.7%; p= 0.007). For the inpatient admission of G65, the use of anticoagulants (p < 0.001) and comorbidity (p = 0.002) played a primary role, while for younger patients it was more neurological symptoms (p < 0.001) and alcohol (p < 0.001) that led to inpatient monitoring. The mean length of hospitalization of G65 patients was significantly longer than that of younger patients (G65 2.4 ± 1.9 days > U65 1.7 ± 0.8 days; p = 0.007) and radiological examinations (G65 94.7% > U65 23.3%; p = 0.013) were performed more frequently. Comparing analysis of the cost and proceeds of U65 vs. G65 results in a proceeds difference of €51,753.91 per year for the G-DRG B80Z compared to U65. Conclusions: It has been shown that there is a difference in costs and proceeds when comparing younger and older patients, resulting in a reimbursement deficit. In view of the demographic development in Europe, flat-rate remuneration will lead to a considerable discrepancy between DRG reimbursement and the coverage of hospitals’ running costs. Providing health care to an increasingly aging society represents one of the major personnel and financial challenges for the public health system in the coming decades. Further adaptation of the DRG system to the growing costs caused by older patients is imperative.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%