ArticleUnfallchirurgie (Heidelberg, Germany)2025
[Potential consequences of the German hospital reform and the resolution of the Federal Joint Committee on the treatment of proximal femoral fractures for the Federal State of Saxony : Improvement or hazard for the quality of care?]
Article in Unfallchirurgie (Heidelberg, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- When demography challenges policy: the rising burden of proximal femur fractures as a role model and driver for geriatric trauma care in Germany.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Operative timing and surgical complexity in hand trauma: a multicenter analysis of replantation and non-replantation centers in Germany.Archives of orthopaedic and trauma surgery · 2026Article
- Prevalence of acute kidney injury in geriatric patients: Equal contribution of arthroplasty and osteosynthesis of the proximal femur.SAGE open medicine · 2026Article
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Authors and funding
5 authors.
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Abstract
backgroundThe German hospital landscape is undergoing comprehensive changes due to the increasing aging population and staff shortages in the healthcare sector. These changes are driven by the current hospital reform and the guidelines of the Federal Joint Committee (G-BA) for the treatment of proximal femoral fractures.
objectiveTo investigate the effects of the hospital reform and the implementation of the G‑BA guidelines for the treatment of proximal femoral fractures in Saxony.
methodsBased on the number of proximal femoral fracture surgeries performed in all certified trauma centers in Saxony (East Saxony/West Saxony Trauma Network) in 2019 and 2022, a simulation was conducted to visualize the implementation of the G‑BA guidelines and the hospital reform.
resultsApplying the criteria of the G‑BA resolution results in a reduction of hospitals treating proximal femoral fractures in Saxony from 42 to 28 (-33%). The implementation of the planned hospital reform further reduces the number of such hospitals to 15 (-64%). This reduction leads to a significant increase in case numbers in the remaining hospitals (twofold to threefold) and up to a fourfold increase by 2030. This comes with an increased need for operating capacities (1.2 operating rooms per week) and about 7400 secondary transfers per year. In the districts of North Saxony, Bautzen, Central Saxony, and the Erzgebirge District, no hospital would be available to treat geriatric proximal femoral fractures.
conclusionThe planned reform and the current implementation of the G‑BA resolution pose a high risk to create gaps in care in Saxony with a markedly reduced number of hospitals involved in treatment of proximal femoral fractures. The necessary operating resources and inpatient capacities in the remaining hospitals are insufficient to care for the expected number of patients given the personnel and capacity shortages.
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