Related Experiment Video
Updated: May 14, 2025
Vascular Casting of Adult and Early Postnatal Mouse Lungs for Micro-CT Imaging
Published on: June 20, 2020
Financial Implications Associated With the Use of Waterproof Casting Material in Pediatric Patients
Alexis L Clifford1, Aaron Jennings1, Catalina Baez2
1College of Medicine.
Insights
Waterproof cast liners significantly reduce unplanned recasting in pediatric fractures compared to standard cotton liners. Despite higher initial material costs, waterproof casting proves cost-effective by minimizing overall healthcare utilization and associated expenses.
Area of Science:
- Orthopedics
- Pediatric Care
- Health Economics
Background:
- Waterproof casting materials enhance patient experience but face adoption barriers due to higher raw material costs.
- This study addresses the need to compare healthcare utilization and financial implications of waterproof versus standard cotton liners for pediatric nonoperative fractures.
Purpose of the Study:
- To compare unplanned healthcare utilization between waterproof and standard cotton cast liners in pediatric patients with nonoperative fractures.
- To analyze the financial implications, including recasting rates and overall costs, associated with each type of cast liner.
Main Methods:
- A retrospective chart review of 977 pediatric nonoperative fractures treated with either standard or waterproof cast liners.
- Statistical analysis using generalized logistic and linear models to assess recasting rates and associated costs.
- Calculation of Incremental Cost Effectiveness Ratio (ICER) to evaluate cost-effectiveness.
Main Results:
- Waterproof casts had significantly lower recasting rates (11.6%) compared to standard casts (43.3%).
- Unplanned recasting rates were also significantly lower for waterproof casts (7.5%) versus standard casts (23.8%).
- Waterproof liners incurred an average additional material cost of $16.46, with an ICER of $81.42.
Conclusions:
- Standard cotton liners are linked to higher unplanned recasting rates.
- While waterproof liners have greater initial material costs, they are cost-effective when considering the reduction in unplanned recasting and associated healthcare utilization.
- The study supports waterproof casting as a financially viable option despite higher upfront material expenses.
Background:
Waterproof casting materials have been demonstrated to improve the patient experience through subjective patient satisfaction and discomfort measures. However, the increased cost of raw materials has limited its wide adoption as a standard of care. The purpose of this study was to compare unplanned healthcare utilization and the financial implications of using waterproof versus cotton liners for nonoperative fractures in pediatric patients.
Methods:
A single institution retrospective chart review analyzed 950 pediatric patients with 977 nonoperative upper and lower extremity fractures who received either standard or waterproof cast liners from January 1, 2020, to December 31, 2021. Generalized logistic and linear models were used to determine whether cast liner material was associated with recasting and to what extent this was associated with the total cost of casting materials over the course of fracture care. Incremental Cost Effectiveness Ratio (ICER) was calculated based on casting material costs and the likelihood of unplanned cast changes between groups.
Results:
Of the 977 castings included, 804 (82.3%) had standard casts, and 173 (17.7%) had waterproof casts placed as initial treatment. The proportion of casts requiring recasting was significantly higher in patients with standard casts (43.3%) compared with those with waterproof casts (11.6%) ( P <0.001). Similarly, the rate of unplanned recasting was higher in the standard cast group (23.8%) than in the waterproof cast group (7.5%) ( P <0.001). When accounting for factors affecting cost in nonoperative fracture care, casts with waterproof lining were, on average, $16.46 more expensive than standard ( P <0.001). The ICER for waterproof cast liners was $81.42.
Conclusions:
The findings of this study show that standard cotton liners are associated with increased unplanned recasting rates. While only accounting for raw material costs to the provider, waterproof liner material costs were greater than standard. However, we argue that waterproof casting is cost-effective when considering other associated costs with unplanned recasting, such as application time and additional visits.
Level Of Evidence:
Level III.
More Related Videos
Related Concept Videos
01:22Waterproofing and Anti-Bacterial Admixtures in Concrete
Waterproofing admixtures render concrete hydrophobic,...
01:20Cavity Drainage and Flashings in Masonry walls
Weep holes, strategically placed at the base of the cavity, are critical for draining accumulated water. These openings are created by leaving head...