setting at a fraction of the cost."
Research backs up that claim. A recent study including 61 patients
who had ankle fractures — among the most common traumatic ortho-
pedic injuries — surgically repaired at a tertiary referral hospital and
81 patients who received treatment in the hospital's surgery center
says outpatient ankle fracture repairs cost 31.6% less than inpatient
cases (osmag.net/B8SgcU).
"The main factors contributing to the higher costs were the labor
and facility expenses," says study co-author Clayton C. Bettin, MD, an
orthopedic surgeon at Campbell Clinic Orthopaedics in Memphis,
Tenn. "We also found there were no differences in rates of reopera-
tion, readmission or return visits to the ER for patients treated on an
inpatient or outpatient basis."
Another study comparing the costs of inpatient and outpatient frac-
ture repairs says routine hospitalizations for ankle repair surgery result
in about $367 million in facility reimbursements each year. In 2012,
according to the study, inpatient ankle surgeries resulted in nearly $8
million in facility reimbursements, compared with a little more than $4
million in payments to outpatient facilities for treatment of the same
injuries. The study notes that a greater understanding of the economic
implications of inpatient ankle fracture surgery could lead to more pro-
cedures being performed on an outpatient basis.
Is it time to add fracture repair to your case mix? In this era of
value-based surgical care, the choice appears obvious.
Getting started
"Fractures of the finger, wrist, ankle, forearm, elbow or humerus that
don't affect nerves or the vascular system can be treated acutely with a
splint, and scheduled electively in an outpatient facility," says Dr.
Romeo.
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