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[Analysis of variation in the surgical treatment of distal radius fracture]
M M J Walenkamp1, M A M Mulders, C A Selles
1*Dit onderzoek werd eerder gepubliceerd in Journal of Hand Surgery (European Volume) (2017;42:39-44) met als titel 'Analysis of variation in the surgical treatment of patients with distal radial fractures in the Netherlands'. Afgedrukt met toestemming van SAGE Publications, Ltd.
Objective:
The optimum treatment of patients with distal radius fracture has not been entirely clarified resulting in possible major variations between hospitals in the number of patients undergoing surgical treatment. The objective of this study was to examine the variation in surgical treatment rates of patients with distal radius fractures across Dutch hospitals.
Design:
Retrospective study.
Method:
Aggregated data for all patients with a distal radius fracture were obtained for 2012 and 2013 on the basis of reimbursement codes. The surgical rate across hospitals was corrected for several variables using linear regression analysis.
Results:
We analysed a total of 95,754 reimbursements. The operative rate ranged from 0% to 23%, with a mean of 9.6%. Hospital type, the percentage of females, the percentage of patients over 65, the mean age, average socioeconomic status, and the total number of patients treated explained only 2.6% of the observed differences in operative rate between hospitals in 2012 and 11.6% in 2013.
Conclusion:
Our results suggest that non-scientific factors, such as surgeon's age, background, and local culture, influence therapeutic decisions in patients with distal radius fractures.