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Your search keyword '"Fracture Fixation, Internal/economics"' showing total 2 results
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2 results on '"Fracture Fixation, Internal/economics"'

1. Cost-effectiveness of on-demand removal of syndesmotic screws.

Author

Penning, D., Sanders, F. R. K., van Dieren, S., Roukema, G. R., Vermeulen, J., Winkelhagen, J., Goslings, J. C., Schepers, T., van den Bekerom, M. P., van Dijkman, B., Halm, J. A., Hoogendoorn, J. M., Parkkinen, M., and van Veen, R. N.

Subjects
MEDICAL device removal, ANKLE fractures, BONE screws, SPRAINS, MEDICAL care costs, ANKLE injuries, COST effectiveness, RESEARCH funding, FRACTURE fixation, QUALITY of life
Abstract

Purpose: Syndesmotic screw removal following acute syndesmotic injury is a commonly performed procedure. However, recent studies suggest that the removal does not result in improved patient reported outcome, while the procedure has proved not to be without complications. The aim of this study was to present a health-economic evaluation of on-demand removal (ODR) compared to routine removal (RR) of the syndesmotic screw. Methods: Data were collected from the RODEO trial, a randomized controlled non-inferiority trial comparing functional outcome of ODR with RR. Economic evaluation resulted in total costs, costs (in Euro) per quality adjusted life year (QALY) and costs per point improvement on the Olerud Molander Ankle Score (OMAS). This included both direct and indirect costs. Results: Total costs for ODR were significantly lower with a mean difference of 3160 euro compared to RR (p < 0.001). The difference in QALY was not significant. The difference in OMAS at 12 months was 1.79 with an incremental cost-effectiveness ratio (ICER) of €-1763 (p = 0.512). The ICER was well below the willingness to pay. Although unit costs might vary between hospitals and countries, these results provide relevant data of cost-effectiveness. Conclusion: The clinical effectiveness of both ODR and RR can be considered equal. The costs are lower for patients treated with ODR, which leads to the conclusion that ODR is cost-effective. [ABSTRACT FROM AUTHOR]

Published
2023
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2. Functional outcome and economic burden of operative management of patellar fractures

Author

M. Verschaeve, T. Mennes, Stefaan Nijs, Harm Hoekstra, Maike Reul, Orthopaedics - Traumatology, and Faculty of Law and Criminology

Subjects
Adult, Male, medicine.medical_specialty, Sports medicine, hospital costs, Netherlands/epidemiology, Osteoarthritis, recovery of function, Critical Care and Intensive Care Medicine, Outcome (game theory), Fracture Fixation, Internal/economics, Fracture Fixation, Internal, Fractures, Bone, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Quality of life, Fractures, Bone/surgery, medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Device Removal, Quality Of Life, Netherlands, Aged, Retrospective Studies, 030222 orthopedics, Osteosynthesis, Prostheses and Implants/adverse effects, business.industry, Retrospective cohort study, Patella, Prostheses and Implants, Middle Aged, medicine.disease, Patella/injuries, Postoperative Complications/economics, Emergency Medicine, Physical therapy, Costs and Cost Analysis, Surgery, Female, Patella fracture, Knee injuries, business
Abstract

OBJECTIVES: The complication rate following operative treatment of patellar fractures remains high and is associated with a poor functional outcome. The primary goal of this study was to evaluate our functional outcome of patellar fracture osteosynthesis and define strategies to improve the outcome. The healthcare costs and utilization were calculated. METHODS: All demographic, clinical, radiographic variables and hospital-related costs of 111 patients with 113 surgically treated patellar fractures between January 2005 and December 2014 were analyzed. Fractures were grouped as either simple or complex. Functional outcome was assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS: There were 67 simple fractures (59.3%) and 46 complex fractures (40.7%). The overall complication rate was 48.7%, including 19.5% implant-related complications. In 69 patients (61.1%), implants were removed. The outcome was rather poor, with considerable impairment in all KOOS subscales with the knee-related quality of life rated worst (median 62.5, IQR 37.5-81.25). Poor outcome correlated significantly with complex patellar fractures and extensive tension-band constructs. CONCLUSIONS: The operative treatment of patellar fractures was associated with a high complication rate, functional impairment and reduced quality of life. Complex patellar fractures and extensive tension-band constructs were identified as the main determinants of poor outcome and increased economic burden due to higher reinterventions rates. Strategies to reduce complications and improve outcome should focus on less onerous implants.

Published
2018

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