Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 3, pp 331–337 | Cite as

Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study conducted at a German University Hospital

  • Rene AignerEmail author
  • Juliana Hack
  • Daphne Eschbach
  • Steffen Ruchholtz
  • Matthias Knobe
  • Richard Dodel
  • Benjamin Buecking
Trauma Surgery



Hip fractures have increased medical and socio-economic importance due to demographic transition. Information concerning direct treatment costs and their reimbursement in Germany is lacking.

Materials and methods

Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimbursement. Finally, statistical analysis was performed to identify clinical parameters influencing the cost–reimbursement relation.


Treatment costs were 8853 € (95% CI 8297–9410 €), while reimbursement was 8196 € (95% CI 7707–8772 €), resulting in a deficit of 657 € (95% CI 143–1117 €). Bivariate analysis showed that the cost–reimbursement relation was negatively influenced mainly by higher age, higher ASA score, readmission to the intensive care unit (ICU) and red blood cell transfusion. Adjusted for other parameters, readmission to the ICU was a significant negative predictor (− 2669 €; 95% CI – 4070 to − 1268 €; p < 0.001), while age of 60–75 years was a positive predictor for the cost–reimbursement relation (1373 €; 95% CI 265–2480 €; p = 0.015).


Treatment of geriatric hip fracture patients in a university hospital in Germany does not seem to be cost-covering. Adjustment of the reimbursement for treatment of complex hip fracture patients should be considered.


Ortho-geriatrics Geriatric fracture Hip fracture Cost-effectiveness Treatment costs 



The authors would like to thank Mr. Gerd Bodenbender for his support in determining the treatment costs.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Rene Aigner
    • 1
    Email author
  • Juliana Hack
    • 1
  • Daphne Eschbach
    • 1
  • Steffen Ruchholtz
    • 1
  • Matthias Knobe
    • 3
  • Richard Dodel
    • 2
  • Benjamin Buecking
    • 1
  1. 1.Center for Orthopaedics and Trauma SurgeryUniversity Hospital Giessen and Marburg GmbHMarburgGermany
  2. 2.Department of NeurologyUniversity Hospital Giessen and MarburgMarburgGermany
  3. 3.Department of Trauma and Reconstructive SurgeryUniversity Hospital RWTH AachenAachenGermany

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