title: DRG reimbursement: geriatric hip fractures in the community hospital trauma center.
abstract: BACKGROUND
  The purpose of this paper was to determine whether Medicare reimbursement for hip fracture reaches cost in geriatric patients.
  
  
  METHODS
  We conducted a retrospective review using the hospital trauma registry. Demographics, operations, length of stay, clinical outcome, discharge disposition, hospital charges, and hospital costs were reviewed and compared with diagnosis-related group (DRG) reimbursement.
  
  
  RESULTS
  The study included 153 Medicare patients. Mortality was 3.9%, 71% were discharged to a nursing home or rehabilitation unit, and 25% went directly home. DRG reimbursement constituted 58% of charges. Compared with costs, the DRG amount represented a mean loss of nearly $1,000 per patient.
  
  
  CONCLUSIONS
  DRG reimbursement undercompensates the community hospital trauma center for treating a common malady among the geriatric population. A population shift toward the elderly, decreasing Medicare remuneration, and the advance of managed care will make correct identification and control of costs extremely important for the hospital caring for hip fractures in the geriatric population.
authors.affiliation: Department of Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA.
authors.forename: T
authors.initials: T
authors.lastname: Clancy
authors.forename: S
authors.initials: S
authors.lastname: Kitchen
authors.forename: P
authors.initials: P
authors.lastname: Churchill
authors.forename: D
authors.initials: D
authors.lastname: Covington
authors.forename: J
authors.initials: J
authors.lastname: Hundley
authors.forename: J G
authors.initials: JG
authors.lastname: Maxwell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003363:Cost Control / Q000639:trends; D003953:Diagnosis-Related Groups / Q000191:economics*; D005544:Forecasting; D006620:Hip Fractures / Q000191:economics* / Q000401:mortality / Q000601:surgery; D017721:Hospital Costs / Q000706:statistics & numerical data; D006764:Hospitals, Community / Q000191:economics; D006801:Humans; D006278:Medicare / Q000191:economics*; D012042:Registries; D012051:Reimbursement Mechanisms / Q000191:economics*; D012189:Retrospective Studies; D015996:Survival Rate; D014193:Trauma Centers / Q000191:economics*; D014481:United States