Health Care Utilization and Out-of-Pocket Expenses in the 30-, 60-, and 90-Day Postoperative Period After Hand Trauma

There are knowledge gaps about postsurgical utilization and spending after hand trauma, which has implications for outcomes and access to care.

Using 2019-2022 national claims, we examined 30-, 60-, and 90-day postsurgical health care utilization and out-of-pocket (OOP) expenses of flexor tendon repairs, open reduction internal fixation (ORIF) of a distal radius fracture, and digital replantation/revascularization. Multivariable regression models were used to examine the association between characteristics and postsurgical utilization and OOP expenses.

Among 22 170 patients, a large proportion of patients had utilization within 30 days (19 188; 87%), 60 days (20 022; 91%), and 90 days (20 170; 92%) after surgery, translating to OOP expenses of $41 at 30 days versus $107 at 90 days with substantial procedural variation (eg, 90-day OOP expenses after ORIF of a distal radius fracture of $98 vs $211 for flexor tendon repair). Patients undergoing flexor tendon repair had greater odds of reoperation/hospitalization at 30 days (adjusted odds ratio [aOR] = 1.8, 95% confidence interval [CI] = 1.5-2.1), 60 days (aOR = 1.8, 95% CI = 1.5-2.0), and 90 days (aOR = 1.6, 95% CI = 1.4-1.8) compared with ORIF of distal radius fractures. Flexor tendon repair was associated with 52% greater OOP expenses at 30 days (95% CI = 1.4-1.6) and 33% greater OOP expenses at 90 days (95% CI = 1.2-1.4) compared with ORIF of distal radius fractures.

There was substantial variation in utilization and patient OOP expenses 30, 60, and 90 days postoperatively. These findings can help inform policy and practice leaders as they implement strategies to minimize patient financial burden of health care.