Abstract
In order to define strategies to curb the continuing increase in healthcare costs, we describe the cost breakdown of open tibial fractures. Twenty-seven clinical and process variables were recorded retrospectively, and five main hospital related cost categories were defined. Three multivariate linear models were fitted to the data. Total healthcare costs of open tibial fractures were almost twice as high compared to closed fractures and mainly existed of hospitalization costs. Length-of-stay (LOS) was found to be the most important variable driving the healthcare costs of open tibial fractures. Deep infection lead to a 6-fold increase of LOS and 5-fold increase in total healthcare costs of open tibial fractures. Therefore, appropriate international consensus guidelines are required to improve not only the patient outcome (infection prevention) but also reduce overall healthcare cost by focusing on reducing the LOS.
Highlights
Healthcare costs have increased significantly over the past decades
Total healthcare costs of open tibial fractures were almost double as high compared to closed fractures
After exclusion of all process variables related to hospital stay, deep infection was identified as the most important clinical parameter driving the LOS and total healthcare costs of open tibial fractures
Summary
Healthcare costs have increased significantly over the past decades. In Belgium, health expenditure currently accounts for approximately 10% of its GDP (gross domestic product), up from 8% in 2000 [1]. This puts Belgium on the top 10 list of OECD (Organization for Economic Co-operation and Development) countries with the highest healthcare expenditure, which is led by the United States with 16.4% [2]. We reported an exploratory analysis of the healthcare costs associated with the treatment of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopedic Trauma Association) type 44-B ankle fractures and defined strategies (e.g. immediate percutaneous intramedullary fibular fixation) to curb the continuing increase in healthcare costs [3]. Length-of-stay (LOS) was identified here as the main driver of the total healthcare costs
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