Direct medical costs of interprosthetic femoral fracture treatment: A cohort analysis.

摘要: ABSTRACT Introduction : Periprosthetic femoral fractures (PPFs) represent a challenging clinical problem with fast-rising incidence. Interprosthetic (IPFs) one of its most difficult variants. There is paucity data regarding the financial burden PPFs, and none for IPFs. This study aims to estimate direct medical cost surgical treatment IPFs in NHS, analyse factors influencing this when using different methods Methods A cohort patients treated single academic unit over period 8-years was studied. In-hospital details, as well outpatient follow-up data, were gathered relevant their radiological outcome until discharge. Local national NHS acquired from department, industry-related resources. The economic analysis structured identification (CIA) overall cohort, but also comparative best-case scenario (uncomplicated course till discharge) comparison between 3 main management strategies (a) revision arthroplasty (RTHA), b) plate fixation (ORIF), c) combination implants (COMBO). Results Data 28 (22 females) analysed median age 78.4 years. treating £468,330, £15.625 (range £10,128 33,060). Comparing three modalities, groups a, b, c £20,793 £12,110 £24,116), £12,979 £20,555), £22,316 £10,938 £23,081) respectively. In all groups, 2/3 identified costs inpatient stay. Transfusions highest (3 units cRBC on average) that received THA vs other two (p=0.022). statistically significant higher mean RTHA ORIF (£19,453 vs. £14,201, p=0.0242), not compared COMBO cases £18,788, p=0.86). Conclusion first “best case scenario” demonstrated cost, managing these complex variable contemporary techniques. Evidence based reimbursement should be developed allow sustainability service we offer patient population.