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The costs of operative complications for ankle fractures: a case control study.

Avilucea FR, Greenberg SE, Grantham WJ, Sathiyakumar V, Thakore RV, Nwosu SK, Archer KR, Obremskey WT, Mir HR, Sethi MK - Adv Orthop (2014)

Bottom Line: As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications.Length of stay and median costs were significantly higher for cases than controls.Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system.

View Article: PubMed Central - PubMed

Affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, 1215 21st Avenue S., MCE, South Tower, Suite 4200, Vanderbilt University, Nashville, TN 37232, USA.

ABSTRACT
As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications. Considering that surgical treatment of ankle fractures is common, there remains minimal data relating costs to postsurgical intervention. We aimed to identify costs associated with ankle fracture complications through case-control analysis. Using retrospective analysis at a level I trauma center, 28 patients with isolated ankle fractures who developed complications (cases) were matched with 28 isolated ankle fracture patients without complications (controls) based on ASA score, age, surgery type, and fracture type. Patient charts were reviewed for demographics and complications leading to readmission/reoperation and costs were obtained from the financial department. Wilcoxon tests measured differences in the costs between the cases and controls. 28 out of 439 patients (6.4%) developed complications. Length of stay and median costs were significantly higher for cases than controls. Specifically, differences in total costs existed for infection and hardware-related pain. This is the first study to highlight the considerable costs associated with the treatment of complications due to isolated ankle fractures. Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system.

No MeSH data available.


Related in: MedlinePlus

Aggregate technical charges for cases and controls are broken down into diagnostic, room at board (R&B), surgical materials and implants (materials), pharmacy, and total charges. Median values are repotted.
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fig2: Aggregate technical charges for cases and controls are broken down into diagnostic, room at board (R&B), surgical materials and implants (materials), pharmacy, and total charges. Median values are repotted.

Mentions: Figures 1 and 2 detail the aggregate professional and technical charges, respectively, for the 28 patients within each group. The cases had higher aggregate costs in each category except for radiology charges. In sum, the 28 cases had an aggregate professional and technical charge of $3,090,331 compared to $1,637,589 for the 28 controls.


The costs of operative complications for ankle fractures: a case control study.

Avilucea FR, Greenberg SE, Grantham WJ, Sathiyakumar V, Thakore RV, Nwosu SK, Archer KR, Obremskey WT, Mir HR, Sethi MK - Adv Orthop (2014)

Aggregate technical charges for cases and controls are broken down into diagnostic, room at board (R&B), surgical materials and implants (materials), pharmacy, and total charges. Median values are repotted.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265548&req=5

fig2: Aggregate technical charges for cases and controls are broken down into diagnostic, room at board (R&B), surgical materials and implants (materials), pharmacy, and total charges. Median values are repotted.
Mentions: Figures 1 and 2 detail the aggregate professional and technical charges, respectively, for the 28 patients within each group. The cases had higher aggregate costs in each category except for radiology charges. In sum, the 28 cases had an aggregate professional and technical charge of $3,090,331 compared to $1,637,589 for the 28 controls.

Bottom Line: As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications.Length of stay and median costs were significantly higher for cases than controls.Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system.

View Article: PubMed Central - PubMed

Affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, 1215 21st Avenue S., MCE, South Tower, Suite 4200, Vanderbilt University, Nashville, TN 37232, USA.

ABSTRACT
As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications. Considering that surgical treatment of ankle fractures is common, there remains minimal data relating costs to postsurgical intervention. We aimed to identify costs associated with ankle fracture complications through case-control analysis. Using retrospective analysis at a level I trauma center, 28 patients with isolated ankle fractures who developed complications (cases) were matched with 28 isolated ankle fracture patients without complications (controls) based on ASA score, age, surgery type, and fracture type. Patient charts were reviewed for demographics and complications leading to readmission/reoperation and costs were obtained from the financial department. Wilcoxon tests measured differences in the costs between the cases and controls. 28 out of 439 patients (6.4%) developed complications. Length of stay and median costs were significantly higher for cases than controls. Specifically, differences in total costs existed for infection and hardware-related pain. This is the first study to highlight the considerable costs associated with the treatment of complications due to isolated ankle fractures. Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system.

No MeSH data available.


Related in: MedlinePlus