Out-of-Pocket Expenses Associated with Hand Trauma: A 12-Month Analysis After Injury.

Area of Science:

• Orthopedic Surgery
• Health Economics
• Health Services Research

Background:

• Hand injuries present significant financial challenges, potentially delaying treatment and affecting patient outcomes.
• Limited data exists on the specific patient, injury, and health system factors influencing out-of-pocket (OOP) expenses for hand trauma care.

Purpose of the Study:

• To investigate the key drivers of patient OOP expenses following surgical treatment for hand trauma.
• To compare OOP expenses between patients treated at public safety-net hospitals versus private community hospitals.

Main Methods:

• A retrospective study analyzed data from 2016-2023 on patients undergoing surgical hand trauma treatment.
• Patients were categorized into two cohorts: public safety-net hospital and private community hospital.
• Out-of-pocket expenses were tracked at 3, 6, and 12 months post-operatively, with generalized linear models used to assess influencing factors.

Main Results:

• The study included 819 patients at the safety-net hospital and 313 at the private hospital.
• Twelve-month OOP expenses were significantly lower at private hospitals (37% of safety-net hospital costs).
• Patients with commercial insurance incurred higher OOP expenses than those with Medicare/Medicaid across both settings.

Conclusions:

• Insurance coverage and hospital setting are primary determinants of OOP expenses for surgically treated hand trauma.
• Patient and injury-specific factors did not significantly impact these costs.
• Findings underscore the necessity for policies promoting price transparency and mitigating patient financial toxicity.