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Effect of facility on the operative costs of distal radius fractures.

Publication ,  Journal Article
Mather, RC; Wysocki, RW; Mack Aldridge, J; Pietrobon, R; Nunley, JA
Published in: J Hand Surg Am
July 2011

PURPOSE: The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. METHODS: We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. RESULTS: The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. CONCLUSIONS: The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic and Decisional Analysis III.

Duke Scholars

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

July 2011

Volume

36

Issue

7

Start / End Page

1142 / 1148

Location

United States

Related Subject Headings

  • Wrist Injuries
  • Retrospective Studies
  • Radius Fractures
  • Radiography
  • Orthopedics
  • North Carolina
  • Multivariate Analysis
  • Male
  • Linear Models
  • Length of Stay
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mather, R. C., Wysocki, R. W., Mack Aldridge, J., Pietrobon, R., & Nunley, J. A. (2011). Effect of facility on the operative costs of distal radius fractures. J Hand Surg Am, 36(7), 1142–1148. https://doi.org/10.1016/j.jhsa.2011.03.042
Mather, Richard C., Robert W. Wysocki, J. Mack Aldridge, Ricardo Pietrobon, and James A. Nunley. “Effect of facility on the operative costs of distal radius fractures.J Hand Surg Am 36, no. 7 (July 2011): 1142–48. https://doi.org/10.1016/j.jhsa.2011.03.042.
Mather RC, Wysocki RW, Mack Aldridge J, Pietrobon R, Nunley JA. Effect of facility on the operative costs of distal radius fractures. J Hand Surg Am. 2011 Jul;36(7):1142–8.
Mather, Richard C., et al. “Effect of facility on the operative costs of distal radius fractures.J Hand Surg Am, vol. 36, no. 7, July 2011, pp. 1142–48. Pubmed, doi:10.1016/j.jhsa.2011.03.042.
Mather RC, Wysocki RW, Mack Aldridge J, Pietrobon R, Nunley JA. Effect of facility on the operative costs of distal radius fractures. J Hand Surg Am. 2011 Jul;36(7):1142–1148.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

July 2011

Volume

36

Issue

7

Start / End Page

1142 / 1148

Location

United States

Related Subject Headings

  • Wrist Injuries
  • Retrospective Studies
  • Radius Fractures
  • Radiography
  • Orthopedics
  • North Carolina
  • Multivariate Analysis
  • Male
  • Linear Models
  • Length of Stay