Osteologie/Osteology · Feb 23, 2026
Orthogeriatric co-management in the EvaCom study: How much geriatrics is required?
By Rapp K
INTRODUCTION: In Germany, fragility fractures are treated in centers that have a) no orthogeriatric co-management (OGCM), b) OGCM but no certification, and c) OGCM with certification (ATZ). The aim is to show to what extent these models of care, the certification process, and the organization of OGCM influence new prescriptions for antiosteoporotic medication, subsequent fractures, and mortality. METHODS: The observational study was conducted using nationwide routinely collected data from 2014 to 2018 from the AOK Research Institute (WIdO). Patients with an acute hip fracture aged at least 80 years were included. The endpoints were new prescriptions for antiosteoporotic medications, a secondary ‚Major Osteoporotic Fracture‘ (MOF: hip, pelvis, vertebral body, upper arm, forearm) after hip fracture, and mortality. RESULTS: Data from almost 100.000 hip fracture patients were analyzed. Compared with centers without OGCM, specific antiosteoporotic medications were prescribed more than twice as frequently following treatment in ATZs. The prescription rate increased markedly during the certification period. The risk of a secondary MOF was reduced in centers with OGCM compared with centers without OGCM. When only ATZs were considered, hospitals with a high level of geriatric presence had lower mortality than hospitals providing only geriatric consultation services. DISCUSSION: The data show that OGCM, particularly with continuous geriatric presence, leads to better care and better outcomes in Germany.