Costs Associated With Geriatric Ankle Fractures

Area of Science:

• Orthopaedic surgery
• Geriatric medicine
• Health economics

Background:

• Ankle fractures are a common orthopaedic injury in geriatric patients.
• Operative management shows mortality benefits but requires careful case-by-case consideration.
• Understanding treatment outcomes and costs is crucial for value-based healthcare analysis.

Purpose of the Study:

• To analyze inpatient and readmission costs for operative versus nonoperative management of geriatric ankle fractures.

Main Methods:

• Retrospective analysis of Medicare Part A claims data from 2008.
• Inclusion of patients aged 65 and older with ankle fractures.
• Identification of operative versus nonoperative treatment using ICD-9 codes.
• Collection of data on age, comorbidities, and readmissions.
• Determination of inpatient costs using Medicare reimbursement data.

Main Results:

• A total of 19,648 geriatric ankle fracture patients were analyzed.
• Initial admission costs were higher for operative ($8798.10) versus nonoperative ($5097.20) management (P < .05).
• Readmission costs were similar between nonoperative ($5161.50) and operative ($5071.40) groups (P > .05).
• Total combined costs for initial treatment and readmissions were approximately $185 million.

Conclusions:

• Total expenditures for geriatric ankle fractures are substantial and likely increasing.
• Readmissions account for a significant portion (nearly one-sixth) of total costs.
• Future research should focus on identifying patients who benefit from operative intervention and optimizing care to reduce readmission costs.