From Henry Ford Health, Detroit, MI.
J Am Acad Orthop Surg Glob Res Rev. 2023 Nov 17;7(11). doi: 10.5435/JAAOSGlobal-D-23-00173. eCollection 2023 Nov 1.
Although hand trauma care has proved to be profitable, loss of trauma patients from a system may lead to revenue loss. Our study aimed to (1) elucidate the economic effect of hand trauma programs, (2) quantify the potential fiscal effect of loss of follow-up, and (3) determine factors contributing to leakage of patients from the healthcare system.
Revenue data were retrospectively extracted for all adult hand trauma patients within a multicenter healthcare system from 2014 to 2018. Demographic and encounter factors were analyzed using Wilcoxon rank-sum test for differences in continuous variables, Pearson chi square test for categorical variables, and odds ratios. A follow-up model was created using logistic regression.
A total of 56,995 (31% new, 69% established) hand trauma encounters were recorded. Follow-up was markedly affected by many factors, including new vs. established patients. Of the 17,748 new patients, 8638 (48.6%) returned for subsequent care, generating $34M. The patients who did not return may have lost $176M for the system.
Many factors lead to loss of follow-up. Understanding these factors can help target efforts to minimize leakage of hand trauma patients. Hand trauma introduces new patients to hospitals, generating notable revenue. Leakage of hand trauma patients has substantial revenue losses.
手部创伤护理已被证明有利可图，但失去创伤患者可能导致收入损失。本研究旨在：(1)阐明手部创伤计划的经济效应；(2)量化失去随访的潜在财政影响；(3)确定导致患者从医疗体系中流失的因素。
回顾性提取了 2014 年至 2018 年间多中心医疗系统内所有成年手部创伤患者的收入数据。使用 Wilcoxon 秩和检验比较连续变量的差异，使用 Pearson 卡方检验比较分类变量的差异，使用优势比分析患者特征与随访的关系。使用逻辑回归建立随访模型。
共记录了 56995 例（31%为新患者，69%为旧患者）手部创伤就诊。随访受到许多因素的显著影响，包括新患者和旧患者。在 17748 例新患者中，有 8638 例（48.6%）返回接受后续治疗，为系统带来了 3400 万美元的收入。未返回的患者可能导致系统损失了 1.76 亿美元。
许多因素导致随访流失。了解这些因素可以帮助针对手部创伤患者流失问题采取措施。手部创伤为医院带来新患者，产生可观的收入。手部创伤患者的流失导致了大量的收入损失。
