Cost description of inpatient treatment for ankle fracture

Murray, Ashley M.; McDonald, Sinead; Archbold, P.; Crealey, Grainne

doi:10.1016/j.injury.2010.08.023

Cited by 56 publications

(38 citation statements)

References 13 publications

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“…In-hospital cost for osseous ankle fractures cost €4,000/case in our study, which was in line with data from Murray et al reported £4730 ( i.e. , €4230) [47]. The fact that the age effect was larger in females than in males may reflect that females tend to outlive their partners; elderly are more prone to losing their independence after sustaining a foot or ankle injury.…”

Section: Discussionsupporting

confidence: 90%

Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986–2010

Boer

Schepers

Panneman

et al. 2014

BMC Musculoskelet Disord

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BackgroundFoot and ankle injuries account for a large proportion of Emergency Department attendance. The aim of this study was to assess population-based trends in attendances due to foot and ankle injuries in the Netherlands since 1986, and to provide a detailed analysis of health care costs in these patients.MethodsAge- and gender-standardized emergency attendance rates and incidence rates for hospital admission were calculated for each year of the study. Injury cases and hospital length of stay were extracted from the National Injury Surveillance System (non-hospitalized patients) and the National Medical Registration (hospitalized patients). Data were grouped into osseous and ligamentous injuries for foot and ankle separately. An incidence-based cost model was applied to calculate associated direct health care costs.ResultsSince 1986 the overall emergency attendance rate decreased from 858 to 640 per 100,000 person years. In non-admitted patients (90% of cases), ligamentous injuries approximately halved, whereas osseous injuries increased by 28% (foot) and 25% (ankle). The incidence rate for hospital admission increased by 35%, mainly due to an almost doubling of osseous injuries. Attendance rates showed a peak in adolescents and adults until ~45 years of age in males and (less pronounced) in females. The total number of hospital days decreased to 58,708 days in 2010. Hospital length of stay (HLOS) increased with age and was highest for osseous injuries. HLOS was unaffected by gender, apart for longer stay in elderly females with an osseous ankle injury. Health care costs per case were highest for osseous injuries of the ankle (€ 3,461). Costs were higher for females and increased with age to € 6,023 in elderly males and € 10,949 in elderly females. Main cost determinants were in-hospital care (56% of total costs), rehabilitation/nursing care (15%), and physical therapy (12%).ConclusionsSince 1986, the emergency attendance rate of foot and ankle injuries in the Netherlands decreased by 25%. Throughout the years, the attendance rate of (relatively simple) ligamentous injuries strongly reduced, whereas osseous injuries nearly doubled. Attendance rates and health care costs were gender- and age-related. Main cost determinants were in-hospital care, rehabilitation/nursing care, and physical therapy.

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Section: Discussionsupporting

confidence: 90%

Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986–2010

Boer

Schepers

Panneman

et al. 2014

BMC Musculoskelet Disord

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“…Ankle fractures are associated with high costs for both the affected individual and society. These costs are related not only to the operation and subsequent hospitalization, but also to the duration of occupational disability [ 5 – 8 ]. To reduce these latter costs, early functional return is crucial [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Weight-Bearing and Mobilization in the Postoperative Care of Ankle Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies

et al. 2015

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PurposeTo determine the effectiveness and safety of interventions used for rehabilitation after open reduction and internal fixation of ankle fractures.MethodsA systematic review and meta-analysis was performed using both randomized trials and cohort studies. The effect of mobilization, weight-bearing, and unprotected weight-bearing as tolerated on postoperative recovery was compared using the Olerud Molander score, return to work/daily activities, and the rate of complications.ResultsA total of 25 articles were included. Ankle exercises resulted in earlier return to work and/or daily activities compared to immobilization (mean difference (MD) -20.76 days; 95% confidence interval (CI) -40.02 to -1.50). There was no difference in the rate of complications between exercises and immobilization (risk ratio (RR) 1.22; 95% CI 0.60 to 2.45) or between early and late weight-bearing (RR 1.26; 95%CI 0.56 to 2.85).InterpretationResults of this meta-analysis show that following ankle surgery, 1) active exercises accelerate return to work and daily activities compared to immobilization, 2) early weight-bearing tends to accelerate return to work and daily activities compared to late weight-bearing. Active exercises in combination with immediate weight-bearing may be a safe option.

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“…Although not specifically assessed in this study, the mode of fixation utilized is known to have variable costs. Murray et al reported that external fixation of ankle fractures results in greater financial expenditures compared to open reduction internal fixation [ 5 ]. Moreover, locking plate technology is more costly than a standard plate.…”

Section: Discussionmentioning

confidence: 99%

“…Manoukian et al investigated ankle fracture costs based on the timing of operation in relation to when patients are admitted to the hospital, but their analysis did not focus on complications or specific areas of costs during the hospitalization [ 4 ]. Additionally, Murray and colleagues investigated index hospitalization and readmission costs for ankle fracture patients based on type of surgery; however, the authors did not identify reasons for readmission based on type of complication [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Costs of Operative Complications for Ankle Fractures: A Case Control Study

Avilucea

Greenberg

Grantham

et al. 2014

Advances in Orthopedics

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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.

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Cost description of inpatient treatment for ankle fracture

Cited by 56 publications

References 13 publications

Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986–2010

Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986–2010

Weight-Bearing and Mobilization in the Postoperative Care of Ankle Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies

The Costs of Operative Complications for Ankle Fractures: A Case Control Study

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