Proefschrift

Economic burden of the postoperative management in peri- and/or intra-articular fractures of the lower extremities 43 Patient outcome measures During the rehabilitation, a total of N=11 (20.8%) fracture related postoperative complications were found (N=6 superficial infections, N=1 deep infection, N=1 nonunions, N=2 secondary dislocation of osteosynthesis material and N=1 early removal of osteosynthesis material due to pain). No significant differences were found in total mean costs between patients with or without complications (Table 4.4). Table 4.4 Costs during 26 weeks of rehabilitation between patients with and without complications. Total population N=53 Patients with complications (N=11) Patients without complications (N=42) p-value Costs during 26 weeks of rehabilitation Mean healthcare costs, (SD) 6,912.18 (7,518.21) 6,718.13 (7,824.99) NS Mean productivity loss costs, (SD) 4,276.85 (5,246.54) 2,541.97 (3,875.43) NS Mean patient and family costs, (SD) 217.21 (136.34) 262.66 (164.09) NS Mean overall costs, (SD) 11,748.36 (7,517.81) 9,716.61 (8,115.67) NS Data in cells are in Euros (€), SD; standard deviation, NS; not significant Discussion This study found that the costs of surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities following a non-weight bearing protocol was, on average, €9,836.96 during 26 weeks of rehabilitation. Significant higher costs were observed for patients without a paid job compared to those with paid job. This difference was mainly caused by the healthcare costs of this group. Furthermore, no significant differences in the perceived performance in ADL were observed over the follow up period as measured with the LEFS. This study did observe an improvement of utility over time. Finally, the mean total costs in patients with complications were not significantly different to those of patients without complications. In our study the majority of the incurred costs during the 26 weeks of rehabilitation were healthcare costs. The healthcare costs accounted for 68.7% of the total costs. The total costs during the 26 weeks of rehabilitation were two times more than the mean healthcare expenses reported in the literature of €4,462.00 per person per year.27 Furthermore, the group of patients without paid job had 2.9% higher total costs than the patients with paid job. Additionally, the group of patients without paid job had 31.1% lower productivity losses and there healthcare costs were significantly higher (61.3%) than the patients with paid job. There were several possible reasons for these outcomes: first, some patients with paid job may have been able to work, paid

RkJQdWJsaXNoZXIy MjY0ODMw