Patients may have financial burden, worry associated with orthopedic trauma injuries
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Key takeaways:
- Patients reported a substantial amount of financial burden after an orthopedic trauma injury.
- Results showed 10% and 30% of patients reported a high degree of financial burden and worry, respectively.
SEATTLE — Patients with orthopedic trauma injuries may experience financial burden and worry associated with their injury regardless of insurance, employment status or access to paid leave, according to results presented here.
“As orthopedic surgeons, we need to look out for patients suffering from financial distress following their injury and mobilize what resources you do have access to, to help improve their overall experience,” Devon T. Brameier, BMBCh, BSc, said in her presentation at the Orthopaedic Trauma Association Annual Meeting.
Substantial financial burden
To identify the potential risks and protective factors for financial distress related to orthopedic trauma, Brameier and colleagues collected surveys from 127 patients undergoing surgery for an orthopedic trauma injury at baseline and 3, 6 and 12 months postoperatively. Brameier said the surveys included the financial burden composite (FBC) score and the dichotomized worry (DW) score.
“The FBC score is a validated score on a scale of zero to six, with a score greater than four [being] indicative of high financial burden, while the DW score is a validated score on a zero to 100 scale, with a score greater than 60 indicating high degrees of financial burden,” Brameier said.
Researchers found 99% of patients had some form of medical insurance and 50% of patients were employed at the time of injury. Of those, 62% of patients had access to paid medical leave. Brameier also said 13% of patients had preexisting medical debt, defined as having debt of at least $1,000.
“Patients reported a substantial amount of financial burden at 3, 6 and 12 months,” Brameier said. “The degree of financial burden they reported is similar to previous studies investigating patients with new diagnoses of cancer and recent heart attacks, and we did see there was no change in this burden through the entire year time course.”
Worry scores may decrease
According to Brameier, about 33% of patients had to use savings due to their injury; about 11% of patients had to borrow money, take out a loan or were unable to make bill payments; and about 10% of patients did not attend physical therapy appointments due to the financial burden from their injury. She added 10% of patients reported a high degree of financial burden and 30% of patients reported high degrees of worry related to their financial well-being because of their injury at 3 months. Although financial burden scores showed a nonsignificant trend of decreasing with time, Brameier said the DW score had a significant decrease by the 12-month mark.
“We found age was strongly negatively correlated with financial burden and moderately negatively correlated with financial worry. Our retired patients reported significantly less financial burden and worry than our employed patients at the time of injury,” Brameier said. “We also found that the strongest predictor of financial burden and worry was having had preexisting medical debt of at least $1,000 and factors such as insurance status, education and access to paid sick leave were not protected against this financial burden.”
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Brameier DT, et al. Paper 92. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 18-21, 2023; Seattle.
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