Australian Research Collaboration on Hands (ARCH), Mudgeeraba, QLD, Australia.
Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.
J Hand Surg Asian Pac Vol. 2023 Jun;28(3):369-376. doi: 10.1142/S242483552350039X. Epub 2023 May 5.
To compare the observed healthcare and societal costs of intramedullary screw (IMS) and plate fixation of extra-articular metacarpal and phalangeal fractures in a contemporary Australian context. A retrospective analysis, based on previously published data, was performed utilising information from Australian public and private hospitals, the Medicare Benefits Schedule (MBS) and the Australian Bureau of Statistics. Plate fixation demonstrated longer surgical lengths (32 minutes, compared to 25 minutes), greater hardware costs (AUD 1,088 vs. AUD 355), more extended follow-up requirements (6.3 months, compared to 5 months) and higher rates of subsequent hardware removal (24% compared to 4.6%), resulting in an increased healthcare expenditure of AUD 1,519.41 in the public system, and AUD 1,698.59 in the private sector. Wage losses were estimated at AUD 15,515.78 when the fracture cohort is fixed by a plate, and AUD 13,542.43 when using an IMS - a differential of AUD 1,973.35. There is a substantial saving to both the health system and the patient when using IMS fixation over dorsal plating for the fixation of extra-articular metacarpal and phalangeal fractures. Level III (Cost Utility).
比较在当代澳大利亚背景下髓内钉 (IMS) 和钢板固定关节外掌骨和指骨骨折的观察到的医疗保健和社会成本。基于先前发表的数据，利用来自澳大利亚公立医院和私立医院、医疗保险福利计划 (MBS) 和澳大利亚统计局的信息进行了回顾性分析。钢板固定的手术时间更长 (32 分钟，而 25 分钟)，硬件成本更高 (AUD 1088 澳元比 AUD 355 澳元)，随访要求更长 (6.3 个月，而 5 个月)，随后去除硬件的比例更高 (24%比 4.6%)，导致公共系统的医疗支出增加了 1519.41 澳元，私人部门增加了 1698.59 澳元。当使用钢板固定骨折队列时，估计工资损失为 15515.78 澳元，而当使用 IMS 时为 13542.43 澳元，相差 1973.35 澳元。对于关节外掌骨和指骨骨折的固定，与使用钢板固定相比，使用 IMS 固定可使医疗系统和患者都有大量节省。三级（成本效益）。
