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[The costs of hip-fracture in Germany: a prospective evaluation]
1Medizinisch-Geriatrische Klinik, Augusta-Kranken-Anstalt gGmbH, Dr. -C.-Otto-Str. 27, D-44789 Bochum.
Objective:
To assess the direct and indirect costs of hip fracture in dependence of postoperative care setting.
Study Design:
Prospective cohort study.
Methods:
227 consecutive patients in three hospitals (city, town, and small town) presenting with hip fracture. For 177 patients there was follow-up regarding post-operative care-setting. During follow-up the cost of the remaining patient at 1, 3, 6 month were recorded and afterwards adjusted to the distribution of the initial cohort. To obtain information on patient characteristics, assessment during hospital stay and follow up have been performed.
Results:
There was a relevant difference in costs depending on the care setting after hip fracture. The nursing home - nursing home, community - community, and community - nursing home resulted in total costs at 6 month of 17,701 DM, 27,102 DM and 54, 503 DM, respectively (average: 24,508 DM). Nursing home costs contributed significantly to the differences between groups. Valid and predictive measures could not be established in first analysis of performed assessments.
Conclusion:
Due to the high incidence of hip fractures (100,000/y) indirect costs play a major role in the economic impact of this illness. The analysis of the effectiveness of interventions has to take into account these costs to achieve adequate conclusions.