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ORIF less costly vs hemiarthroplasty in management of proximal humerus fractures
In the management of proximal humerus fractures, open reduction and internal fixation was less costly than hemiarthroplasty, according to results.
Researchers evaluated Medicare claims data from the Upstate New York area from January 2008 to September 2009 and included 109 patients treated with either open reduction and internal fixation (ORIF, n=52) or hemiarthroplasty for proximal humerus fractures (n=57). In-hospital costs and total health care costs within 90 days after the index operation were included as primary end points.
Ilya Voloshin
Univariate analysis showed increased in-hospital and total costs of surgical management of proximal humerus fractures were significantly associated with readmissions, non-routine discharge, comorbidities and complications. Researchers found readmission had the greatest effect on in-hospital patient costs and total patient costs at $54,345 and $63,104, respectively. This was followed by any complication, which on average increased in-hospital patient costs by $23,330 and total patient costs by $30,237, according to results. ORIF had a mean in-hospital cost of $14,967 vs. $20,508 for hemiarthroplasty, researchers noted.
According to multivariable analysis, ORIF was associated with 29% lower in-patient cost vs. hemiarthroplasty after adjustment for relevant clinical variables. Results showed costs were also independently increased by readmission, non-routine discharge and Elixhauser Comorbidity Index greater than 1. – by Casey Tingle
Disclosures: Thorsness reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.