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Randomized Controlled Trial
. 2020 Jul;140(7):877-886.
doi: 10.1007/s00402-019-03309-1. Epub 2019 Nov 23.

Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Esther M M Van Lieshout  1 , Gijs I T Iordens  1 , Suzanne Polinder  2 , Denise Eygendaal  3 , Michael H J Verhofstad  1 , Niels W L Schep  4 , Dennis Den Hartog  5 ; FuncSiE Trial Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial

Esther M M Van Lieshout et al. Arch Orthop Trauma Surg. 2020 Jul.

Abstract

Introduction: The primary aim was to assess and compare the total costs (direct health care costs and indirect costs due to loss of production) after early mobilization versus plaster immobilization in patients with a simple elbow dislocation. It was hypothesized that early mobilization would not lead to higher direct and indirect costs.

Materials and methods: This study used data of a multicenter randomized clinical trial (FuncSiE trial). From August 25, 2009 until September 18, 2012, 100 adult patients with a simple elbow dislocation were recruited and randomized to early mobilization (immediate motion exercises; n = 48) or 3 weeks plaster immobilization (n = 52). Patients completed questionnaires on health-related quality of life [EuroQoL-5D (EQ-5D) and Short Form-36 (SF-36 PCS and SF-36 MCS)], health care use, and work absence. Follow-up was 1 year. Primary outcome were the total costs at 1 year. Analysis was by intention to treat.

Results: There were no significant differences in EQ-5D, SF-36 PCS, and SF-36 MCS between the two groups. Mean total costs per patient were €3624 in the early mobilization group versus €7072 in the plaster group (p = 0.094). Shorter work absenteeism in the early mobilization group (10 versus 18 days; p = 0.027) did not lead to significantly lower costs for loss of productivity (€1719 in the early mobilization group versus €4589; p = 0.120).

Conclusion: From a clinical and a socio-economic point of view, early mobilization should be the treatment of choice for a simple elbow dislocation. Plaster immobilization has inferior results at almost double the cost.

Keywords: Cost utility; Cost-effectiveness; Elbow dislocation; Function; Quality of life.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Trial flow chart
Fig. 2
Fig. 2
Mean total costs and costs per cost category by treatment group
See this image and copyright information in PMC

References

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