[The costs of hip-fracture in Germany: a prospective evaluation].
OBJECTIVE
To assess the direct and indirect costs of hip fracture in dependence of postoperative care setting.


METHODS
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.


CONCLUSIONS
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.
Pientka
L
L
Medizinisch-Geriatrische Klinik, Augusta-Kranken-Anstalt gGmbH, Dr. -C.-Otto-Str. 27, D-44789 Bochum.
Friedrich
C
C
D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D004180:Direct Service Costs / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D005858:Germany; D006620:Hip Fractures / Q000191:economics* / Q000534:rehabilitation; D006707:Homes for the Aged / Q000191:economics; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics; D011182:Postoperative Care / Q000191:economics; D011446:Prospective Studies