دورية أكاديمية
أعرض في EDS

Characteristics and Hospital Costs of Spica Cast Treatment of Non-accidental-related Diaphyseal Femoral Fractures in Children Before Walking Age.

التفاصيل البيبلوغرافية
العنوان: Characteristics and Hospital Costs of Spica Cast Treatment of Non-accidental-related Diaphyseal Femoral Fractures in Children Before Walking Age.
المؤلفون: Magee LC; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA., Mahmoud MAH, Baldwin K, Talwar D, Gandhi JS, Arkader A
المصدر: Journal of pediatric orthopedics [J Pediatr Orthop] 2020 Nov/Dec; Vol. 40 (10), pp. e932-e935.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: New York Ny : Raven Press
مواضيع طبية MeSH: Battered Child Syndrome/*economics , Battered Child Syndrome/*therapy , Femoral Fractures/*economics , Femoral Fractures/*therapy, Casts, Surgical/economics ; Child Abuse ; Female ; Femur ; Health Care Costs/statistics & numerical data ; Hospital Costs ; Hospitals ; Humans ; Infant ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Male ; Radiography/statistics & numerical data ; Retrospective Studies
مستخلص: Background: Fractures are one of the most common presentations of child abuse second only to soft tissue damage, with ∼60% of fractures being femur, humerus or tibia fractures. Although studies have shown increased health care costs associated with nonaccidental trauma (NAT), there is little data regarding the cost of NAT-associated fractures compared with accidental trauma (AT) related fractures. The purpose of this study was to consider the economic burden of NAT related femoral fractures compared with AT femoral fractures.
Methods: We performed a retrospective study of children under the age of one with femoral fractures treated with a spica cast at a Level 1 Pediatric Trauma Center between 2007 and 2016. Variables included age, sex, length of hospital stay, and estimated total billing cost obtained from this hospital's billing department. In addition, fracture site (mid-shaft, distal, proximal, and subtrochanteric) and pattern were assessed.
Results: Sixty children with a mean age of 7 months were analyzed. NAT was suspected in 19 cases (31.7%) and confirmed in 9 (15%) before discharge. Two groups were analyzed: the NAT group included suspected and confirmed cases of abuse (28) and the AT group contained the remaining 32 cases. There was no significant difference in the demographics between these 2 groups. Children in NAT group had a longer length of stay compared with AT group (78.9 vs. 36.7 h, P<0.001). Overall consumer price index-adjusted hospital costs were $24,726 higher for NAT group compared with AT group (P=0.024), with costs of laboratory workup, radiology, and nonorthopaedic physician fees being the top 3 components contributing to the increased costs.
Conclusions: The overall incidence of NAT was 46.6% in children presenting with femoral fracture under 1 year of age. The overall hospital cost of treating fractures in the NAT group was 1.5 times higher than the AT group, with imaging charges the most significant contributor to cost difference.
Level of Evidence: Level III-retrospective review.
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تواريخ الأحداث: Date Created: 20200803 Date Completed: 20210211 Latest Revision: 20210211
رمز التحديث: 20231215
DOI: 10.1097/BPO.0000000000001577
PMID: 32740177
قاعدة البيانات: MEDLINE
الوصف
تدمد:1539-2570
DOI:10.1097/BPO.0000000000001577