Elsevier

Injury

Volume 42, Issue 11, November 2011, Pages 1226-1229
Injury

Cost description of inpatient treatment for ankle fracture

https://doi.org/10.1016/j.injury.2010.08.023Get rights and content

Abstract

Background

The study estimated the hospital costs associated with the surgical fixation of ankle fractures by either open reduction internal fixation (ORIF) or external fixation.

Method

A retrospective review of the clinical records of all 264 patients admitted with an ankle fracture requiring surgical stabilisation between 1 March 2007 and 29 February 2008. Patient records were examined for a minimum of 6 months after primary admission. A mean cost per patient was calculated based on patient-level hospital resource use. This included all procedures received during both their primary hospitalisation and subsequent re-admissions.

Results

Approximately equal numbers of males and females (mean age 46.2 years) were admitted, and males were significantly younger than females. The mean length of stay was 10.8 days (SD 9.1); however, ORIF (which was performed in the vast majority of cases, 94.7%) was associated with a much shorter mean length of stay compared with external fixation (10.4 days; SD 8.9 vs. 17.4 days; SD 10.2). The mean total hospital cost per patient including was £4730.28 (SD £2340.73) with a higher mean cost for those who received external fixation as the primary procedure (£9453.92; SD £3391.84) compared with ORIF (£4465.76; SD £1965.10). Patients with severe health problems had significantly higher costs than fit and healthy patients (£5982.65; SD £28 77.74 vs. £4375.00; SD £1957.65).

Conclusions

The results highlight the considerable hospital costs associated with the surgical fixation of an ankle fracture, thus providing valuable information for resource planners. Future research should broaden the perspective of the economic analysis to include rehabilitation costs and assess the cost-effectiveness of potential cost-saving strategies.

Section snippets

Patients and methods

The study was carried out at the Royal Victoria Hospital (RVH), Belfast, where data are collected prospectively on all fracture admissions and recorded in the Fracture Outcomes Research Database (FORD). The present study was a retrospective review of the clinical records of all 264 patients admitted to the RVH fracture unit between 1 March 2007 and 29 February 2008 with an ankle fracture that required surgical stabilisation. Patient records were examined for a minimum of 6 months after primary

Results

The mean age of patients was 46.2 years (ranging from 14.0 years to 89.9 years). Approximately equal numbers of males and females required admission to the fracture unit (49.2%; 130/264 vs. 50.8%; 134/264); however, male patients were significantly younger than females (mean age 39.2 years vs. 52.8 years; p < 0.001). On admission to the fracture ward, patients were classified according to their co-morbidity. The majority of patients were fit and healthy (70.1%; 185/264), 18.6% (49/264) had mild

Discussion

The NHS continues to face increasing cost pressures, and in the current financial climate, it needs to focus on efficiency and productivity while continuing to provide safe and quality services for patients. To help achieve this, it needs better information on quality, costs and activity.

In our institution in Belfast, the overall mean cost per patient for the in-hospital treatment for acute ankle fracture was calculated to be £4730. Higher mean costs were observed in the small number of

Conflicts of interest

None.

Acknowledgement

The authors would like to thank two anonymous reviewers for helpful comments on an earlier version of the article.

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