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The economic burden of outpatient appointments following paediatric fractures
Anne Guro Vreim Holm1, Hilde Lurås2, Per-Henrik Randsborg1
1Department of Orthopedic Surgery, Akershus University Hospital, 1478 Lørenskog, Norway.
Insights
Paediatric fracture follow-ups incur significant costs for families and society. A streamlined management protocol could reduce unnecessary appointments, improving efficiency in paediatric fracture care.
Area of Science:
- Orthopedic Surgery
- Pediatric Healthcare Economics
Background:
- Paediatric fractures are common, necessitating frequent follow-up appointments.
- The economic impact on families and society from these appointments is substantial.
Purpose of the Study:
- To quantify the direct private costs for families and societal costs (productivity loss) associated with paediatric fracture clinic follow-ups.
- To assess the medical appropriateness and impact on treatment management of these follow-up appointments.
Main Methods:
- Prospective data collection using paired parent and surgeon questionnaires from 295 children (aged 6-13) with upper limb fractures.
- Evaluation of appointment necessity and changes in fracture management based on surgeon and parent feedback.
Main Results:
- The estimated direct cost per consultation for families was €48.5, with societal productivity loss at €78.4.
- Surgeons deemed appointments unnecessary in 10.6% of cases, with treatment plans altered in only 6.8%.
- Clavicle fractures were most frequently considered unnecessary for clinical or radiological follow-up.
Conclusions:
- Paediatric fracture follow-ups represent a considerable financial burden on families and society.
- While generally perceived as valuable, these appointments infrequently alter treatment plans, suggesting potential for optimization.
- Implementing stringent management protocols could safely reduce the frequency of clinical and radiological follow-ups for paediatric fractures.
Introduction:
Paediatric fractures are common and frequently followed-up. The aim of this study is to quantify the private costs for the affected families, as well as the costs for society due to paediatric fracture clinic follow-up appointments.
Patients And Methods:
295 paired parent and surgeon questionnaire regarding the cost related to a scheduled follow-up appointment for an upper limb fracture in children aged 6-13 years were collected prospectively over 7 months. In addition, the medical appropriateness of the appointment and whether or not the control changed the management of the fracture was investigated.
Results:
The direct cost of attending a paediatric upper limb fracture clinic was estimated to €48.5 while the cost for society due to productivity loss was €78.4 per consultation. In 89.2% of the cases the surgeons found the appointment necessary, it was deemed unnecessary or inconclusive in 10.6%. The treatment plan was altered in 6.8%, and an extra follow up was scheduled in 5.8%. Fractures of the clavicle were most often regarded as unnecessary to follow up clinically or radiologically by the surgeons.
Discussion:
The direct cost for the affected families and the costs for society due to productivity loss of paediatric fracture follow-up appointments are noticeable. Although most patients and surgeons deem these controls as valuable, they lead to a change in treatment plan in only 12.6% of the cases. A stringent management protocol can safely reduce the number of clinical and radiographical follow-ups.
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