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. 2017 Sep 25;7(1):32.
doi: 10.1186/s13561-017-0168-0.

Economics of open tibial fractures: the pivotal role of length-of-stay and infection

Harm Hoekstra  1   2 , Bart Smeets  3 , Willem-Jan Metsemakers  4 , Anne-Cécile Spitz  5 , Stefaan Nijs  4   6
Affiliations

Economics of open tibial fractures: the pivotal role of length-of-stay and infection

Harm Hoekstra et al. Health Econ Rev. .

Abstract

In order to define strategies to curb the continuing increase in healthcare costs, we describe the cost breakdown of open tibial fractures. Twenty-seven clinical and process variables were recorded retrospectively, and five main hospital related cost categories were defined. Three multivariate linear models were fitted to the data. Total healthcare costs of open tibial fractures were almost twice as high compared to closed fractures and mainly existed of hospitalization costs. Length-of-stay (LOS) was found to be the most important variable driving the healthcare costs of open tibial fractures. Deep infection lead to a 6-fold increase of LOS and 5-fold increase in total healthcare costs of open tibial fractures. Therefore, appropriate international consensus guidelines are required to improve not only the patient outcome (infection prevention) but also reduce overall healthcare cost by focusing on reducing the LOS.

Keywords: Costs analysis; Healthcare financing; Open tibial fractures.

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Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Distribution of total healthcare costs for patients with and without open tibial fractures
Fig. 2
Fig. 2
Distribution of total healthcare costs for patients with deep infection of open tibial fractures
Fig. 3
Fig. 3
Distribution of total healthcare costs for patients with AO/OTA type 41, 42 and 43 open tibial fractures
Fig. 4
Fig. 4
Distribution of total healthcare costs for patients with Gustilo type 1, 2 and 3 open tibial fractures
See this image and copyright information in PMC

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