{"title":"与儿科患者使用防水铸造材料相关的财务影响。","authors":"Alexis L Clifford, Aaron Jennings, Catalina Baez, Emily Boschert, Stephanie Ihnow, Jessica McQuerry","doi":"10.1097/BPO.0000000000002978","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e693-e700"},"PeriodicalIF":1.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Financial Implications Associated With the Use of Waterproof Casting Material in Pediatric Patients.\",\"authors\":\"Alexis L Clifford, Aaron Jennings, Catalina Baez, Emily Boschert, Stephanie Ihnow, Jessica McQuerry\",\"doi\":\"10.1097/BPO.0000000000002978\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":16945,\"journal\":{\"name\":\"Journal of Pediatric Orthopaedics\",\"volume\":\" \",\"pages\":\"e693-e700\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BPO.0000000000002978\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BPO.0000000000002978","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/11 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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.
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.