Abstract
Both private and socialized healthcare systems require treatments to be not only effective, but also cost-efficient. Although the Ponseti method of clubfoot treatment is effective, its cost-effectiveness has not been demonstrated. We compared the difference in resource use between two prospective cohorts treated for clubfoot by either the Ponseti method or below-knee casting followed by primary surgical release in the socialized healthcare system of New Zealand. Using these cohorts and US billing data, costs of treating these cohorts in the US healthcare system were also calculated. Treatment of initial deformity, recurrences, and complications in both cohorts were included in the final assessment. Twenty-six patients (40 feet) were enrolled in the Ponseti cohort and 29 (46 feet) in the primary surgical cohort. For most patients, the Ponseti method was more cost-effective than the primary surgical treatment in both healthcare systems. The cost of treating both cohorts was lower in the socialized system than in the US healthcare system.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Acknowledgments
We thank Jan E. Davison, the clubfoot nurse specialist at Starship Children’s Health Auckland, New Zealand, for her time and effort in caring for these children. In addition, we thank Jan for her help in preparing the manuscript.
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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
An erratum to this article can be found at http://dx.doi.org/10.1007/s11999-010-1234-7
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Halanski, M.A., Huang, JC., Walsh, S.J. et al. Resource Utilization in Clubfoot Management. Clin Orthop Relat Res 467, 1171–1179 (2009). https://doi.org/10.1007/s11999-008-0674-9
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DOI: https://doi.org/10.1007/s11999-008-0674-9