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Healthcare utilization and related cost of midshaft clavicle fracture treatment in Belgium

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The debate regarding the economic impact and cost effectiveness of surgical midshaft clavicle fracture treatment is ongoing. Variations exist between healthcare systems in terms of financing, provider payment mechanism and the role of the government in all of this. Therefore, the primary aim of our study was to describe the in-hospital-related healthcare costs associated with midshaft clavicle fracture treatment in Belgium. The secondary aim was to define those clinical variables that drive the costs related to surgically treated clavicle fractures and define strategies that could reduce these costs.

Patients and methods

A total of 345 patients with a midshaft clavicle fracture were included in the study. We selected 17 clinical variables and 5 cost categories were defined. Three multivariate linear models were built to determine which parameters drive the costs.

Results

The median total healthcare cost for non-operatively treated patients was €367 and the median total cost for operatively treated patients was €3296. The length-of-stay was the most important variable that predicted the total cost. The clinical variables Number of fracture fragments, Delayed Stage Surgery, Revision Surgery and Infection most influenced the length-of-stay.

Discussion

In conclusion, the initial healthcare utilization cost of operatively treated midshaft clavicle fractures is larger than that of non-operatively treated fractures. The length-of-stay is the most important parameter that drives the cost and is predominantly influenced by patients’ age, fracture complexity and complications requiring a surgical re-intervention.

Level of evidence

III.

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Funding

None of the authors have any financial interests to disclose.

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Authors and Affiliations

  1. Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium

    Michiel Herteleer, Stefaan Nijs & Harm Hoekstra

  2. KU Leuven, University of Leuven, Organ Systems, 3000, Louvain, Belgium

    Michiel Herteleer

  3. KU Leuven, University of Leuven, Faculty of Medicine, 3000, Louvain, Belgium

    Anaïs De Jaegere & Thomas Winckelmans

  4. Imelda Ziekenhuis, Orthopedie, 2820, Bonheiden, Belgium

    Hans Casteur

  5. Department of Development and Regeneration, KU Leuven, University of Leuven, 3000, Louvain, Belgium

    Stefaan Nijs & Harm Hoekstra

Authors
  1. Michiel Herteleer
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  2. Anaïs De Jaegere
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  3. Thomas Winckelmans
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  4. Hans Casteur
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  5. Stefaan Nijs
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  6. Harm Hoekstra
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Corresponding author

Correspondence to Michiel Herteleer.

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None of the authors have any conflict of interest to disclose.

Ethical approval

This study was approved by the ethical committee of UZ Leuven and registered as study s59661.

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Herteleer, M., De Jaegere, A., Winckelmans, T. et al. Healthcare utilization and related cost of midshaft clavicle fracture treatment in Belgium . Eur J Trauma Emerg Surg 47, 1281–1287 (2021). https://doi.org/10.1007/s00068-020-01307-2

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  • DOI: https://doi.org/10.1007/s00068-020-01307-2

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