PMD44 HEALTHCARE RESOURCE UTILIZATION AND PAYMENTS AMONG PATIENTS RECEIVING TREATMENT FOR ACETABULUM FRACTURES

Abstract

To estimate the healthcare resource utilization and medical payments among patients receiving treatment for acetabulum fractures in the United States. This retrospective cohort study included IBM® Marketscan® Commercial and Medicare databases. Adult patients (≥18 years) with a diagnosis of acetabulum fracture who received a treatment with an internal fixation device between 2010-2018 were included. The outcome measures included hospital length of stay (LOS), payments for the initial internal fixation hospitalization, and all-cause readmission and reoperation rates and their associated incremental payments over one-year post-acetabulum surgery. Generalized linear regression models controlling for demographic and clinical factors and method of least-squares means were used to calculate adjusted incremental payments for readmission and reoperation. A total of 1,929 patients in the commercial and 330 patients in Medicare databases were identified. The mean (standard deviation, SD) age of the cohort was 43.0 (14.2) years with 72.9% males in commercial and 75.8 (7.4) years with 57.3% males in Medicare. The mean (SD) hospital LOS were 11.6 (10.5) days and 10.4 (8.8) days and the mean payments for initial treatment hospitalization were $104,213 (119,693) and $49,353 (64,968) for commercial and Medicare populations respectively. Over the one-year post-surgery, the rates of readmission were 28.6% and 37.6% and the adjusted incremental payments were $67,871 and $53,830 for commercial and Medicare populations, respectively. The rates of reoperation were 7.7% and 13.3% and the adjusted incremental payments were $57,841 and $29,663 for commercial and Medicare populations, respectively. Patients receiving treatment for acetabulum fractures not only have long length of stay and burdensome medical payments for initial acetabulum procedure but also have high one-year readmission and reoperation rates and associated incremental payments. Treatment options that could reduce unplanned readmissions and reoperations representing significant potential cost savings to both the hospital and the health care system is warranted.