Känel Samuel, Känel Manuel, Kabelitz Method, Aggeler Kim, Dietrich Michael
Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich, 8092 Zurich, Switzerland.
Clinic for Orthopaedics, Hand- and Trauma Surgery, Stadtspital Zürich, 8037 Zurich, Switzerland.
J Clin Med. 2025 Jun 11;14(12):4149. doi: 10.3390/jcm14124149.
The global number of operatively treated proximal femoral fractures is steadily growing, driven by the demographic shift toward an increasingly elderly, frail, and comorbid population. This clinical condition profoundly impacts not only patient health but also the finances of healthcare systems. The aim of this economic analysis was to investigate the impact on direct costs of orthogeriatric co-management (OGCM) compared to standard of care (SOC). A retrospective analysis was conducted investigating two comparable cohorts of patients aged 75 and above, originating from the exact same geographic area, who underwent surgical treatment for proximal femoral fractures in 2023. The two cohorts differed in their perioperative care protocols: one followed an OGCM ( = 143) protocol, while the other adhered to a SOC protocol ( = 141). Economic data were retrieved from the centralised finance department managing the two hospital sites under investigation. The findings revealed that the OGCM protocol was associated with direct costs that were not higher (CHF 16,019 vs. CHF 16,713, = 0.78) compared to SOC, despite higher daily costs in the OGCM cohort (CHF 2504 vs. CHF 2202, < 0.0001). This difference was largely driven by a significantly shorter length of stay in the OGCM group (6 days vs. 7 days, = 0.002). Optimising resource allocation through tailored geriatric care protocols suggests not only an improvement in clinical outcomes but also a reduction in economic burden, thereby alleviating pressure on the healthcare system.
随着人口结构向老龄化、身体虚弱且患有多种疾病的人群转变，全球接受手术治疗的股骨近端骨折数量在稳步增长。这种临床状况不仅对患者健康产生深远影响，也对医疗系统的财政状况造成影响。本经济分析的目的是研究与标准治疗（SOC）相比，老年骨科联合管理（OGCM）对直接成本的影响。进行了一项回顾性分析，调查了来自同一地理区域的两组年龄在75岁及以上的可比患者队列，他们在2023年接受了股骨近端骨折的手术治疗。这两组患者的围手术期护理方案不同：一组遵循OGCM方案（n = 143），而另一组遵循SOC方案（n = 141）。经济数据从管理所调查的两个医院站点的中央财务部门获取。研究结果显示，与SOC相比，OGCM方案的直接成本并不更高（16,019瑞士法郎对16,713瑞士法郎，p = 0.78），尽管OGCM队列的每日成本更高（2504瑞士法郎对2202瑞士法郎，p < 0.0001）。这种差异主要是由OGCM组显著缩短的住院时间（6天对7天，p = 0.002）驱动的。通过量身定制的老年护理方案优化资源配置，不仅表明临床结果有所改善，而且经济负担有所减轻，从而减轻了医疗系统的压力。
