[Proximal femoral fractures in the elderly. Data from health insurance providers on more than 23 million insured persons--part 2].

Background: The section of geriatric trauma ("AG-Alterstraumatologie") of the"Deutsche Gesellschaft für Unfallchirurgie" (DGU) and the"Lohmann & Birkner Health Care Consulting GmbH" in co-operation with the health insurance funds (VdAK and AEV) supplied the relevant data of approximately 23 million insured persons from the years 2002 to 2004. All data from patients over the age of 60 staying in hospital because of proximal femur fractures and without further injuries as the main diagnosis were extracted from the available amount of data and then analysed.

Results: In comparison to the effective number of beds there was a significant increase in the treatment of proximal femur fractures in hospitals with 101-300 beds. There was no difference in the operative treatment of proximal femur fractures in comparison to the number of beds of the hospital. The average hospital expense for osteosynthesis was 6000 euro per each case and there was no difference in comparison to the different osteosynthetic procedures. The average hospital expense for hip replacement (7036-7201 euro) was about 1000 euro higher than osteosynthetic procedures. There was no difference in the average hospital expense in comparison to the age of the patients.

Conclusion: There was a significant age-dependent increase of acute hospital mortality with a maximum of 8.6% in the group of the patients older than 85 years. As a result of the demographic change fracture rates in the elderly population will rise significantly.