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How Does Traumatic Hand Injury Impact Patients in a Safety-net Healthcare System? A Mixed Methods Study.

Robin T Higashi1, Jessica Lee2, Yadira Hernandez3

  • 1Department of Social and Behavioral Sciences, O'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.

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Traumatic hand injuries significantly impact patients financially and functionally, causing emotional distress and highlighting healthcare system challenges. Enhanced social support is crucial for recovery and well-being.

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Area of Science:

  • Orthopedics
  • Public Health
  • Health Services Research

Background:

  • Traumatic hand injuries disproportionately affect working-age, low-income, and uninsured individuals.
  • Limited understanding exists regarding patient coping mechanisms for functional, economic, and mental health challenges post-injury.
  • Clinician and staff perspectives can illuminate patient burdens and inform support strategies.

Purpose of the Study:

  • Assess the financial health impact of traumatic hand injuries.
  • Evaluate the effect on physical health and disability.
  • Determine the toll on emotional and mental health.
  • Identify health system challenges exacerbating patient stress.

Main Methods:

  • Descriptive study using surveys (COST-FACIT, DASH, InCharge scales) and semistructured interviews.
  • Recruited patients from a safety-net hospital's outpatient hand surgery clinic.
  • Collected data from 83 patients and 26 patients/10 clinicians via interviews.

Main Results:

  • 22% of patients reported high financial toxicity; 65% experienced severe upper-limb disability.
  • Patients described impacts on daily living, finances, and mental health.
  • Shared challenges included inadequate financial processes and social support access.

Conclusions:

  • Traumatic hand injuries lead to cascading financial, emotional, and daily living challenges.
  • Postoperative social services support needs enhancement in intensity and sustainability.
  • Ongoing screening tools and community referrals are recommended.