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. 2013 Winter;21(4):229-33.

Operative trends and physician treatment costs associated with Dupuytren's disease in Canada

Wendy Liu  1 , David B O'Gorman  2 , Bing Siang Gan  3
Affiliations

Operative trends and physician treatment costs associated with Dupuytren's disease in Canada

Wendy Liu et al. Can J Plast Surg. 2013 Winter.

Abstract
in English, French

Purpose: To examine treatment trends and costs associated with Dupuytren's disease (DD) in Canada.

Methods: Data regarding fasciectomies, fasciotomies and digit amputations performed for DD from 2005 to 2010 were extracted from the Canadian Institute for Health Information database. The data were analyzed according to year, sex and five-year age groups. The estimated annual physician reimbursement costs for DD in Ontario were calculated using Ontario Health Insurance Plan billing information and the 2010 Physician Schedule of Benefits.

Results: The number and rate of fasciectomies remained stable from 2005 to 2009 (mean of 4067 and 1.24 per 10,000, respectively), but increased in the 2009/2010 fiscal year (to 4458 and 1.32 per 10,000). The number of fasciotomies increased from 133 in 2005/2006 to 201 in 2008/2009, but dropped to 183 in 2009/2010. The mean number of amputations remained stable (12 procedures).The ratio of males to females undergoing fasciectomies remained stable (4:1). The highest rate of fasciectomies was performed for the age groups 65 to 69 years and 70 to 74 years. Estimated mean physician remuneration for DD in Ontario remained stable ($3.2 million per annum).

Discussion: The results regarding patient demographics are comparable with results from previous literature. There was a trend toward an increasing number of fasciectomies and fasciotomies annually, with fasciotomies increasing faster than fasciectomies, which is reflective of the aging population and the recent attention to fasciotomies in the literature. The present study was the first to investigate treatment trends and physician reimbursement costs for the management of DD in Canada.

Objectif: Examiner les tendances thérapeutiques et les coûts associés à la maladie de Dupuytren (MD) au Canada.

Méthodologie: Les chercheurs ont extrait des bases de données de l’Institut canadien d’information sur la santé les données relatives aux fasciectomies, aux fasciotomies et aux amputations de doigts effectuées en raison de la MD entre 2005 et 2010. Ils ont analysé les données selon l’âge, le sexe et les groupes d’âge par tranches de cinq ans. Ils ont calculé les coûts estimatifs annuels du remboursement des médecins attribuables à la MD en Ontario, au moyen de l’information de facturation tirée du Régime d’assurance-maladie de l’Ontario et du barème des prestations des médecins pour 2010.

Résultats: Le nombre et le taux de fasciectomies sont demeurés stables de 2005 à 2009 (moyenne de 4 067 et de 1,24 sur 10 000, respectivement), mais ont augmenté pendant l’exercice 2009–2010 (à 4 458 et 1,32 sur 10 000). Le nombre de fasciotomies est passé de 133 à 2005–2006 à 201 en 2008–2009, mais a reculé à 183 en 2009–2010. Le nombre moyen d’amputations est demeuré stable (12 interventions). Le ratio d’hommes qui ont subi une fasciectomie par rapport aux femmes est également demeuré stable (4:1). Le plus fort taux de fasciectomies s’observait dans les groupes de 65 à 69 ans et de 70 à 74 ans. Enfin, la rémunération estimative moyenne des médecins pour soigner la MD en Ontario est demeurée stable (3,2 millions de dollars par année).

Exposé: Les résultats relatifs à la démographie des patients sont comparables à ceux des publications antérieures. On a constaté une tendance vers une augmentation annuelle du nombre de fasciectomies et de fasciotomies. L’augmentation des fasciotomies était plus marquée que celle des fasciectomies, ce qui reflète le vieillissement de la population et l’intérêt récent pour les fasciotomies dans les publications. La présente étude était la première à examiner les tendances en matière de traitement et les coûts du remboursement des médecins pour la prise en charge de la MD au Canada.

Keywords: Canada; Dupuytren’s disease; Fasciectomy; Fasciotomy; Physician remuneration; Treatment trends.

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Figures

Figure 1)
Figure 1)
Fasciectomies performed for the treatment of Dupuytren’s disease in Canada remained relatively stable between 2005 and 2009 (from 4062 in 2005/2006 to 4097 in 2008/2009) and increased in 2009/2010 (to 4458). Fasciotomies increased from 133 in 2005/2006 to 201 in 2008/2009, dropping to 183 in 2009/2010. Digit amputations remained relatively stable during this time, with a mean of 12 procedures per fiscal year
Figure 2)
Figure 2)
The rate of fasciectomies performed for the treatment of Dupuytren’s disease in Canada between 2005 and 2010 was determined by dividing the number of fasciectomies by the population for that year and reported per 10,000. The rate of fasciectomies remained relatively stable between 2005 and 2009 (from 1.26 procedures per 10,000 people in 2005/2006 to 1.23 per 10,000 in 2008/2009) and increased slightly in 2009/2010 (to 1.32 per 10,000)
Figure 3)
Figure 3)
The ratio of males to females receiving fasciectomies and fasciotomies for the treatment of Dupuytren’s disease in Canada both remained relatively stable at 4:1 from 2005 to 2010
Figure 4)
Figure 4)
Age-related differences in the number of fasciectomy procedures performed for the treatment of Dupuytren’s disease in Canada from 2005 to 2010 were observed. The greatest numbers of procedures performed were for the 60 to 64 and 65 to 69 years of age groups
Figure 5)
Figure 5)
Age-related differences in the rate of fasciectomy procedures performed for the treatment of Dupuytren’s disease in Canada from 2005 to 2010 were observed. The rate of fasciectomies performed was determined by dividing the number of fasciectomies by the population for that year and reported per 10,000. The highest rates of fasciectomies performed were for the 65 to 69 and 70 to 74 years of age groups, with mean rates of 5.6 and 5.9 per 10,000
Figure 6)
Figure 6)
Cumulative annual physician remuneration for the management of Dupuytren’s disease in Ontario was calculated based on Ontario Health Insurance Plan billing information for 2005 to 2010 and the 2010 Ontario Schedule of Benefits. Physician reimbursement expenditures were calculated based on fee codes deemed appropriate for treatment of Dupuytren’s disease (ie, with excluded odd fee codes). Annual physician billings appeared to remain stable, with a mean value of $3.2 million
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