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Steigende Fallzahlen im Zusammenhang mit einer alternden Bev\u00f6lkerung und eine relativ gro\u00dfe Zahl behandlungsbed\u00fcrftiger Begleiterkrankungen erschweren die allt\u00e4gliche Versorgung. Daher ist die Beobachtung der Versorgungsqualit\u00e4t dieser Patienten anhand relevanter Qualit\u00e4tsparameter von gro\u00dfer Bedeutung, um Implikationen f\u00fcr die allt\u00e4gliche Behandlungspraxis ableiten zu k\u00f6nnen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Die Daten der externen station\u00e4ren Qualit\u00e4tssicherung aus Nordrhein-Westfalen der Jahre 2007 und 2008 sowie 2017 und 2018 wurden analysiert und die Zeitr\u00e4ume vergleichend gegen\u00fcbergestellt. Zus\u00e4tzlich wurde anhand der dokumentierten Nebendiagnosen und weiterer Einflussparameter eine Risikoadjustierung mithilfe eines logistischen Regressionsmodells in Bezug auf die Zielgr\u00f6\u00dfen der allgemeinen und chirurgischen Komplikationen sowie der Letalit\u00e4t durchgef\u00fchrt. Es wurden sowohl osteosynthetisch als auch endoprothetisch versorgte Patienten ber\u00fccksichtigt. Insgesamt konnten 61.249\u00a0F\u00e4lle in die Studie eingeschlossen werden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Positive Entwicklungen konnten im Bereich der chirurgischen Komplikationen und der Wundinfektionen mit R\u00fcckg\u00e4ngen um 1,2\u202f% bzw. 0,8\u202f% beobachtet werden. Bei Vorliegen einer Herz-Kreislauf-Erkrankung war das Outcome der Patienten besonders schlecht. Hierbei zeigten sich f\u00fcr die allgemeinen Komplikationen im Verlauf Verbesserungen in der Subkategorie der kardiovaskul\u00e4ren Ereignisse. Die Letalit\u00e4t lag unver\u00e4ndert bei 6\u202f%. Deutlich gesteigert wurde die operative T\u00e4tigkeit an den Wochenenden. Patienten, deren Krankenhausaufnahme in zeitlichem Bezug zum Wochenende lag, wiesen kein erh\u00f6htes Komplikations- oder Letalit\u00e4tsrisiko auf. Obwohl der Anteil der erst nach \u00fcber 48\u202fh operierten Patienten von 11,4\u202f% auf 8,2\u202f% gesenkt werden konnte, verz\u00f6gert sich die Operation (&gt;\u202f24\u202fh) immer noch in 26,8\u202f% der F\u00e4lle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerungen<\/jats:title>\n                    <jats:p>Vor dem Hintergrund steigender Leistungsanforderungen an das Gesundheitssystem dokumentieren die Ergebnisse Verbesserungen in einigen zentralen Bereichen der station\u00e4ren Behandlung. Dennoch ist die Entwicklung von Strategien zur weiteren Reduktion der pr\u00e4operativen Liegezeiten in medizinisch vertretbarer Weise zu fordern. Internistische Begleiterkrankungen beeinflussen das Outcome der Patienten ma\u00dfgeblich. Somit ist eine ad\u00e4quate Behandlung des multimorbiden Patientenkollektivs auf der Grundlage einer engen Kooperation zwischen alterstraumatologischen und geriatrisch-internistischen Fachabteilungen in der Alltagspraxis zu etablieren.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00113-021-01065-9","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T04:16:00Z","timestamp":1627618560000},"page":"634-646","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Entwicklung der station\u00e4ren Versorgungsqualit\u00e4t operativ behandelter Patienten mit einer proximalen Femurfraktur in Nordrhein-Westfalen","Development of the inpatient quality of care of surgically treated patients with a\u00a0proximal femoral fracture in North Rhine-Westphalia"],"prefix":"10.1007","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7444-0410","authenticated-orcid":false,"given":"C. 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