PMS8 - Hospital Admissions and Inpatient Costs of Non-Union, Delayed Union and Mal-Union Following Long Bone Fracture

Abstract

Previous research into healing complications following long bone fractures has reported a wide range of cost estimates associated with their treatment. This research aims to describe hospital admissions and inpatient costs of hospital readmissions for healing complications following long bone fracture. All femoral, tibial and humeral fractures registered over a 5-year period by the Victorian Orthopaedic Trauma Outcomes Registry were linked with hospital datasets to identify 2-year readmissions for non-union, delayed union or mal-union. Outcomes reported included hospital admissions, length of stay and inpatient costs, derived using a case-mix approach based on Australian National Diagnosis Related Groups (AN-DRG). Out of 3908 patients with long bone fractures, 9% (n=337) were readmitted for healing complications within 2 years of their fracture. The most common type of complication resulting in readmission was non-union (7%). The majority of patients experiencing fracture healing complications were admitted once within two years of their index fracture. However, 12% had 2 admissions for healing complications during this period, 2% had three admissions and 1% (n=2) had four. The total inpatient costs for all admissions for fracture healing complications in this cohort was $5.4MAUD. The median inpatient hospital cost per patient for all complication admissions was $15,000AUD over and above the baseline fracture treatment costs and ranged from $9,500 to $25,000. The median hospital length of stay for all complication admissions was 3 days. Patients who develop fracture healing complications often have multiple admissions for treatment and incur high hospital inpatient costs. There is a need to prioritise future research aimed at preventing fracture healing complications and improving their management in order to reduce the additional burden placed on healthcare systems.