DRG REIMBURSEMENT - GERIATRIC HIP-FRACTURES IN THE COMMUNITY-HOSPITALTRAUMA CENTER

Background. The purpose of this paper was to determine whether Medicar e reimbursement for hip fracture reaches cost in geriatric patients. M ethods. 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 revie wed and compared with diagnosis-related group (DRG) reimbursement. Res ults. The study included 153 Medicare patients. Mortality was 3.9%, 71 % were discharged to a nursing home or rehabilitation unit, and 25% we nt directly home. DRG reimbursement constituted 58% of charges. Compar ed with costs, the DRG amount represented a mean loss of nearly $1,000 per patient. Conclusions. DRG reimbursement undercompensates the comm unity hospital trauma center for treating a common malady among the ge riatric population. A population shift toward the elderly, decreasing Medicare remuneration, and the advance of managed care will make corre ct identification and control of costs extremely important for the hos pital caring for hip fractures in the geriatric population.