Michiel Herteleer1,2, Celien Van Brandt3, Cindy Vandoren4, Stefaan Nijs2,3, Harm Hoekstra5,6. 1. Department of Orthopaedics and Traumatology, Unimedizin Mainz, Mainz, Germany. 2. Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium. 3. Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 4. Management Information and Reporting, University Hospitals Leuven, Leuven, Belgium. 5. Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium. harm.hoekstra@uzleuven.be. 6. Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. harm.hoekstra@uzleuven.be.
Abstract
PURPOSE: We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost. METHODS: National data on tibial plateau fractures were collected from the NIHDI and compared to our performance. Several clinical parameters, such as age, sex, treatment modality and length-of-stay, were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs. RESULTS: Between 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 at our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of non-operatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay. CONCLUSION: Since length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this. LEVEL OF EVIDENCE: Level IV.
PURPOSE: We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost. METHODS: National data on tibial plateau fractures were collected from the NIHDI and compared to our performance. Several clinical parameters, such as age, sex, treatment modality and length-of-stay, were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs. RESULTS: Between 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 at our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of non-operatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay. CONCLUSION: Since length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this. LEVEL OF EVIDENCE: Level IV.
Authors: Markus Bormann; Claas Neidlein; Christoph Gassner; Alexander Martin Keppler; Viktoria Bogner-Flatz; Christian Ehrnthaller; Wolf Christian Prall; Wolfgang Böcker; Julian Fürmetz Journal: Eur J Trauma Emerg Surg Date: 2022-09-03 Impact factor: 2.374
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