Health Care Resource Requirements and Costs During the Recovery Phase of Fasciectomy for the Treatment of Dupuytren's Contracture: Clinician Survey.

Abstract

The average inpatient procedural cost for fasciectomy in Australia is $3,079.57; however this does not capture the true cost of the surgery to the health care system or to society in total. This study sought to determine the extent and cost of health care resource use and productivity loss post-surgical fasciectomy for the treatment of Dupuytren’s contracture (DC) inclusive of medical consultations, allied health care services, and loss of work hours in Australia. A survey of Australian clinicians was performed to inform the estimation of health care resource use and productivity loss during the recovery phase. The survey was sent to 89 hand, orthopaedic and plastic surgeons responsible for the treatment of DC across Australia, with 19 completed surveys received giving a response rate of 21%. Local unit costs were applied to these estimates of resource use and productivity loss. Results from the clinician survey indicated on average the following number of visits to health care professionals were required: 3.2 surgeon, 3.8 physiotherapy, 5.6 occupational therapy, 0.4 home nurse and 0.4 general practitioner visits. Based on this data the resource requirements associated with fasciectomy during the recovery phase were estimated to be $862.18. Loss of productivity informed by the survey suggests 85% of patients in the workforce required time off work for an average of 15.6 days. Based on labour force participation rates by age and gender the average productivity loss was estimated to be 6.1 days at a mean cost of $1,147.18 per patient treated. When considering both the direct health care costs and productivity costs, it was estimated a total of $2009.36 was incurred per patient during the recovery phase following fasciectomy. Fasciectomy for DC is associated with considerable rehabilitation, follow-up and loss of productivity costs which account for a sizable proportion (39%) of total fasciectomy costs.