Centers for geriatric trauma DGU® : Distribution and development in Germany

Stolberg-Stolberg J, Ramadan C, Köppe J, Iking J, Fischhuber K, Blätzinger M, Raschke MJ, Katthagen JC

Abstract

Background: Due to the demographic changes, including the need for more orthogeriatric co-management, addressing the healthcare of geriatric patients is an important issue. Objective: The aim of this study was to create an overview of the fundamental characteristics of centers for geriatric trauma ATZ-DGU including the distribution of departments and cooperations as well as the level of trauma care. The distribution of sites across Germany was compared to hospital and population data. Methods: Certified German ATZ-DGU were assigned to Trauma Center DGU (R) (TC) certification data (levels III-I) via institutional numbers. They were evaluated descriptively and correlations with several parameters at the federal states level were added. Results: Due to cooperations 188 institutions formed 147 ATZ-DGU and 152 provided orthogeriatric co-management in domo. Of the facilities with trauma surgery departments 86% (n = 168) were certified as TCs (level II = 33% > III = 30% > I = 22%). The number of ATZ-DGU per German state was correlated with the number of hospitals (rs = 0.88), inhabitants (rs = 0.92) and cases in total (rs = 0.92, p < 0.001 each) but not with the proportion of people older than 65 years (p > 0.05). With only 14 facilities, the new federal states of Germany seemed to be disadvantaged and also showed great disparities compared to each other. Conclusion: The levels of trauma care revealed a distribution referring to the different focus of the two certificates: treatment of the severely injured vs. geriatric co-treatment. On average, the population in the new German states was older, while there were less ATZ-DGU; however, there seemed to be a slight tendency towards improvement.