Why the study?
Operatively treated proximal femoral fractures in elderly patients profoundly impact healthcare system finances, prompting investigation into the direct cost impact of orthogeriatric co-management versus standard care.
Does orthogeriatric co-management reduce direct costs in patients aged 75 and above undergoing surgical treatment for proximal femoral fractures?
Does orthogeriatric co-management reduce direct costs in patients aged 75 and above undergoing surgical treatment for proximal femoral fractures?
Orthogeriatric co-management for proximal femoral fractures reduces length of stay without increasing overall direct costs compared to standard of care.
May support considering OGCM for shorter stays without added costs in elderly hip fractures; leaves open randomized confirmation before practice change.
Background: The global number of operatively treated proximal femoral fractures is steadily growing, driven by the demographic shift toward an increasingly elderly, frail, and comorbid population. This clinical condition profoundly impacts not only patient health but also the finances of healthcare systems. The aim of this economic analysis was to investigate the impact on direct costs of orthogeriatric co-management (OGCM) compared to standard of care (SOC). Methods: A retrospective analysis was conducted investigating two comparable cohorts of patients aged 75 and above, originating from the exact same geographic area, who underwent surgical treatment for proximal femoral fractures in 2023. The two cohorts differed in their perioperative care protocols: one followed an OGCM (n = 143) protocol, while the other adhered to a SOC protocol (n = 141). Economic data were retrieved from the centralised finance department managing the two hospital sites under investigation. Results: The findings revealed that the OGCM protocol was associated with direct costs that were not higher (CHF 16,019 vs. CHF 16,713, p = 0.78) compared to SOC, despite higher daily costs in the OGCM cohort (CHF 2504 vs. CHF 2202, p < 0.0001). This difference was largely driven by a significantly shorter length of stay in the OGCM group (6 days vs. 7 days, p = 0.002). Conclusions: Optimising resource allocation through tailored geriatric care protocols suggests not only an improvement in clinical outcomes but also a reduction in economic burden, thereby alleviating pressure on the healthcare system.
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Känel et al. (2025) studied this question.
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