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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Costs, epidemiology and post-operative resource use for surgically managed acute hand injuries

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  • Luke Robinson - Monash University, Frankston, Australia
  • presenting/speaker Lisa O'Brien - Monash University, Frankston, Australia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1299

doi: 10.3205/19ifssh1481, urn:nbn:de:0183-19ifssh14812

Published: February 6, 2020

© 2020 Robinson et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Injuries to the hand are common and costly. Most uncomplicated and stable injuries will recover with conservative management, however, some will require surgical intervention. The economic burden placed on the healthcare system from such injuries can be considerable.

Aims: To estimate the economic implications of surgically managed acute hand injuries from a health-care system perspective.

Materials and Methods: Billing records for the 2014-15 financial year at one large hospital were retrospectively reviewed for consecutive patients who received surgical intervention for an acute hand injury following an ED presentation and a minimum of one outpatient appointment. Subsequent financial year data was used to calculate outpatient costs. Costs were calculated from resource use in the ED, inpatient and outpatient settings. Results are presented by demographics, surgery type and mechanism of injury.

Results: 257 individuals, (n=264 surgeries), were included. The total cost of all injuries was $1,292,135.96 with a median cost per case of $4,455.82 (IQR $3,571.02 - $6,070.86). Inpatient costs (77%) accounted for the highest portion of total costs. Nerve injuries (n=41) resulted in the largest median cost per injury ($5402.75 [IQR $4025.69 - $6926.02]), followed by muscle/tendon injuries (n=61) ($4548.09 [IQR $3802.75 - $5808.35]) and fractures (n=155) ($4177.15 [IQR $3356.04 - $5762.26]). The median number of medical and hand therapy appointments was 2.00 (IQR 1.00 - 3.00) and 3.00 (IQR 2.00 - 6.00) respectively.

Conclusions: Surgically managed hand injuries contribute a significant financial burden on the health-care system. Further research using stringent data collection methods is required to establish epidemiological data and national estimates of the cost burden.