[Is there Sense in Having a Certified Centre for Geriatric Trauma Surgery?]

Area of Science:

• Geriatric Medicine
• Trauma Surgery
• Healthcare Management

Background:

• Germany faces a growing elderly population, with 30% expected to be over 70 by 2030.
• An interdisciplinary center for geriatric trauma care was conceptualized in 2009, achieving TÜV (German Technical Inspection Authority) certification.
• The center integrated trauma surgeons, geriatricians, therapists, and pharmacists, with agreed treatment pathways and regular case discussions.

Purpose of the Study:

• To evaluate if the implemented measures improved quality of care for geriatric trauma patients.
• To determine if increased costs associated with the center were covered by its revenue.
• To assess the overall value of establishing such an interdisciplinary center for patients and hospitals.

Main Methods:

• Interdisciplinary treatment was applied to all patients over 70 with proximal femur, proximal humerus, and vertebral fractures.
• Quality control parameters included: admission/diagnosis within 90 minutes, >80% surgery within 24 hours, <12% reoperation rate, <5% decubitus rate, 75% mobilization within 24 hours post-surgery, >80% discharge to home, and minimal mortality.
• Data collected in 2012 and 2013 for patients admitted with these fractures.

Main Results:

• Surgery within 24 hours was achieved in 78% (2012) and 81% (2013). Diagnosis time targets were met by 30% (2012) and 42% (2013).
• Decubitus rates decreased from 8% to 3.2%. Reoperation rates were 5.2% (2012) and 3.1% (2013).
• Mortality for proximal femur fractures decreased from 5.7% (2010) to 3.0% (2013). The center generated €912,000 (2012) and €1.35 million (2013) in revenue.

Conclusions:

• Interdisciplinary geriatric-trauma therapy significantly improved measurable outcomes for older patients.
• The integrated care model, including complex geriatric therapy, proved beneficial for both patient recovery and hospital financial performance.
• The formation of specialized geriatric trauma centers is a worthwhile investment for improving care quality and operational efficiency.