与儿科患者使用防水铸造材料相关的财务影响。

IF 1.5 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2025-09-01 Epub Date: 2025-04-11 DOI:10.1097/BPO.0000000000002978
Alexis L Clifford, Aaron Jennings, Catalina Baez, Emily Boschert, Stephanie Ihnow, Jessica McQuerry
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引用次数: 0

摘要

背景:防水铸造材料已被证明可以通过主观的患者满意度和不适措施来改善患者体验。然而,原材料成本的增加限制了其作为护理标准的广泛采用。本研究的目的是比较儿科非手术性骨折患者使用防水衬垫和棉衬垫的意外医疗保健利用和财务影响。方法:对2020年1月1日至2021年12月31日期间接受标准或防水石膏衬垫治疗的950例小儿上肢和下肢非手术骨折患者进行回顾性分析。使用广义逻辑模型和线性模型来确定铸衬材料是否与重铸有关,以及在断裂护理过程中,这与铸造材料总成本的关联程度。增量成本效益比(ICER)是根据铸造材料成本和组间计划外铸造变化的可能性计算的。结果:977个铸件中,804个(82.3%)为标准铸件,173个(17.7%)为防水铸件。使用标准石膏模的患者需要重铸的比例(43.3%)明显高于使用防水石膏模的患者(11.6%)。(结论:本研究结果表明,使用标准棉衬垫会增加计划外重铸率。虽然只考虑了供应商的原材料成本,但防水衬垫材料成本高于标准。然而,我们认为,当考虑到其他与计划外重铸相关的成本时,如应用时间和额外的访问,防水铸件是具有成本效益的。证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Financial Implications Associated With the Use of Waterproof Casting Material in Pediatric Patients.

Background: Waterproof casting materials have been demonstrated to improve the patient experience through subjective patient satisfaction and discomfort measures. However, the increased cost of raw materials has limited its wide adoption as a standard of care. The purpose of this study was to compare unplanned healthcare utilization and the financial implications of using waterproof versus cotton liners for nonoperative fractures in pediatric patients.

Methods: A single institution retrospective chart review analyzed 950 pediatric patients with 977 nonoperative upper and lower extremity fractures who received either standard or waterproof cast liners from January 1, 2020, to December 31, 2021. Generalized logistic and linear models were used to determine whether cast liner material was associated with recasting and to what extent this was associated with the total cost of casting materials over the course of fracture care. Incremental Cost Effectiveness Ratio (ICER) was calculated based on casting material costs and the likelihood of unplanned cast changes between groups.

Results: Of the 977 castings included, 804 (82.3%) had standard casts, and 173 (17.7%) had waterproof casts placed as initial treatment. The proportion of casts requiring recasting was significantly higher in patients with standard casts (43.3%) compared with those with waterproof casts (11.6%) ( P <0.001). Similarly, the rate of unplanned recasting was higher in the standard cast group (23.8%) than in the waterproof cast group (7.5%) ( P <0.001). When accounting for factors affecting cost in nonoperative fracture care, casts with waterproof lining were, on average, $16.46 more expensive than standard ( P <0.001). The ICER for waterproof cast liners was $81.42.

Conclusions: The findings of this study show that standard cotton liners are associated with increased unplanned recasting rates. While only accounting for raw material costs to the provider, waterproof liner material costs were greater than standard. However, we argue that waterproof casting is cost-effective when considering other associated costs with unplanned recasting, such as application time and additional visits.

Level of evidence: Level III.

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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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