Just A van der Linde1, Judith E Bosmans2, Dirk P Ter Meulen1, Derk A van Kampen3, Derek Fp van Deurzen1, Robert Haverlag4, Daniel Bf Saris5, Michel Pj van den Bekerom1. 1. Department of Orthopedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. 2. Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands. 3. Department of Orthopedic Surgery and Traumatology, Waterlandziekenhuis, Purmerend, the Netherlands. 4. Department of General Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. 5. Department of General Surgery and Traumatology, University Medical Center Utrecht, Utrecht, the Netherlands.
Abstract
BACKGROUND: Shoulder instability is associated with decreased functioning. The associated costs could be substantial and interesting to clinicians, researchers, and policy makers. This prospective observational study aims to (1) estimate productivity losses and healthcare expenses following the nonoperative treatment of shoulder instability and (2) identify patient characteristics that influence societal costs. METHODS: One hundred and thirty-two patients completed a questionnaire regarding production losses and healthcare utilization following consecutive episodes of shoulder instability. Productivity losses were calculated using the friction cost approach. Healthcare utilization was evaluated using standard costs. analysis of variance test was used to assess which patient characteristics are related to productivity losses and healthcare expenses. Societal costs were assessed using multilevel analyses. Bootstrapping was used to estimate statistical uncertainty. RESULTS: Mean productivity losses are €1469, €881, and €728 and mean healthcare expenses are €3759, €3267, and €2424 per patient per dislocation for the first, second, and third dislocation. Productivity losses decrease significantly after the second (mean difference €-1969, 95%CI= -3680 to -939) and third (mean difference €-2298, 95%CI= -4092 to -1288) compared to the first dislocation. CONCLUSIONS: Nonoperative treatment of shoulder instability has substantial societal costs. LEVEL OF EVIDENCE: III, economic analysis.
BACKGROUND: Shoulder instability is associated with decreased functioning. The associated costs could be substantial and interesting to clinicians, researchers, and policy makers. This prospective observational study aims to (1) estimate productivity losses and healthcare expenses following the nonoperative treatment of shoulder instability and (2) identify patient characteristics that influence societal costs. METHODS: One hundred and thirty-two patients completed a questionnaire regarding production losses and healthcare utilization following consecutive episodes of shoulder instability. Productivity losses were calculated using the friction cost approach. Healthcare utilization was evaluated using standard costs. analysis of variance test was used to assess which patient characteristics are related to productivity losses and healthcare expenses. Societal costs were assessed using multilevel analyses. Bootstrapping was used to estimate statistical uncertainty. RESULTS: Mean productivity losses are €1469, €881, and €728 and mean healthcare expenses are €3759, €3267, and €2424 per patient per dislocation for the first, second, and third dislocation. Productivity losses decrease significantly after the second (mean difference €-1969, 95%CI= -3680 to -939) and third (mean difference €-2298, 95%CI= -4092 to -1288) compared to the first dislocation. CONCLUSIONS: Nonoperative treatment of shoulder instability has substantial societal costs. LEVEL OF EVIDENCE: III, economic analysis.
Authors: Ezekiel Emanuel; Neera Tanden; Stuart Altman; Scott Armstrong; Donald Berwick; François de Brantes; Maura Calsyn; Michael Chernew; John Colmers; David Cutler; Tom Daschle; Paul Egerman; Bob Kocher; Arnold Milstein; Emily Oshima Lee; John D Podesta; Uwe Reinhardt; Meredith Rosenthal; Joshua Sharfstein; Stephen Shortell; Andrew Stern; Peter R Orszag; Topher Spiro Journal: N Engl J Med Date: 2012-08-01 Impact factor: 91.245
Authors: Annelies Boonen; Tjinta Brinkhuizen; Robert Landewé; Désirée van der Heijde; Johan L Severens Journal: Ann Rheum Dis Date: 2010-05-03 Impact factor: 19.103
Authors: Lennart Hovelius; Anders Olofsson; Björn Sandström; Bengt-Göran Augustini; Lars Krantz; Hans Fredin; Bo Tillander; Ulf Skoglund; Björn Salomonsson; Jan Nowak; Ulf Sennerby Journal: J Bone Joint Surg Am Date: 2008-05 Impact factor: 5.284
Authors: S Liavaag; S Svenningsen; O Reikerås; M Enger; T Fjalestad; A H Pripp; J I Brox Journal: Scand J Med Sci Sports Date: 2011-04-21 Impact factor: 4.221