Stephen Doxey, Rebekah Kleinsmith, Jeffrey Husband, Deborah Bohn, Brian Cunningham
Objectives:To evaluate six surgeons’ overall experience using cost-effective implants compared to the implants they typically use.Design:Cross-sectional SurveySetting:A Metropolitan Healthcare SystemParticipants:Six surgeons who operatively treat distal radius fractures regularly.Intervention:Surgeons were asked to alternate implant (brand name vs. generic) use in DRF fixation each month. They were then sent a 10-question survey to evaluate their experience with the generic implants. Most questions were rated on a 1-10 Likert scale (1=worst outcome, 10=best outcome). Main Outcome Measurements:Ease of Use and Continued Generic Implant UseResults:All six surgeons completed the survey (100% response rate). Most surgeons completed a hand surgery fellowship (83.3%) and performed their cases in an ambulatory surgery center (83.3%). The average rating for ease of use and how intuitive the system was were 8.8±2.2 and 8.5±1.7. Most surgeons felt that generic implants added little or no extra time to the procedure (4.5±1.0, with 5 being neutral). Most in this group would use generic implants again and recommend them to colleagues (8.2±2.9, 8.0±3.2, respectively).Conclusions:Implant preference is often driven by exposure during residency and fellowship and is minimally evidence-based by comparison. In many instances there is a belief that the value lies in the technology when, in fact, patient selection, surgical technique and post-operative management are more important in determining patient outcome. As cost containment strategies are developed and implemented, we recommend they come from physician leadership, and not top-down administrative mandates.Key Words:Surgeon Behavior, Satisfaction Survey, Implant Cost, Cost Containment Strategy, Generic Implants, Distal Radius FractureLevel of Evidence:Level V
{"title":"Changing Physician Behavior to be More Cost Conscious in Distal Radius Fracture Surgical Management: A Survey Study","authors":"Stephen Doxey, Rebekah Kleinsmith, Jeffrey Husband, Deborah Bohn, Brian Cunningham","doi":"10.55576/job.v3i4.47","DOIUrl":"https://doi.org/10.55576/job.v3i4.47","url":null,"abstract":"Objectives:To evaluate six surgeons’ overall experience using cost-effective implants compared to the implants they typically use.Design:Cross-sectional SurveySetting:A Metropolitan Healthcare SystemParticipants:Six surgeons who operatively treat distal radius fractures regularly.Intervention:Surgeons were asked to alternate implant (brand name vs. generic) use in DRF fixation each month. They were then sent a 10-question survey to evaluate their experience with the generic implants. Most questions were rated on a 1-10 Likert scale (1=worst outcome, 10=best outcome). Main Outcome Measurements:Ease of Use and Continued Generic Implant UseResults:All six surgeons completed the survey (100% response rate). Most surgeons completed a hand surgery fellowship (83.3%) and performed their cases in an ambulatory surgery center (83.3%). The average rating for ease of use and how intuitive the system was were 8.8±2.2 and 8.5±1.7. Most surgeons felt that generic implants added little or no extra time to the procedure (4.5±1.0, with 5 being neutral). Most in this group would use generic implants again and recommend them to colleagues (8.2±2.9, 8.0±3.2, respectively).Conclusions:Implant preference is often driven by exposure during residency and fellowship and is minimally evidence-based by comparison. In many instances there is a belief that the value lies in the technology when, in fact, patient selection, surgical technique and post-operative management are more important in determining patient outcome. As cost containment strategies are developed and implemented, we recommend they come from physician leadership, and not top-down administrative mandates.Key Words:Surgeon Behavior, Satisfaction Survey, Implant Cost, Cost Containment Strategy, Generic Implants, Distal Radius FractureLevel of Evidence:Level V","PeriodicalId":484349,"journal":{"name":"Journal of orthopaedic business","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135408815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacob Albers, Jeffrey B. Brown, Maykel Dolorit, Lauren Ladehoff, Ambuj Kumar, Robert P. Wessel
Purpose
Assessing trends in hospitalization rates due to fractures may be used as an indirect epidemiologic metric to predict future patient volumes, staffing needs, revenue, expenditures, and allocation of resources. The aim of this study is to analyze the trend of hospitalizations for patients who presented to Emergency Departments (EDs) with fractures from 2009 to 2021.
Methods
We extracted data from the National Electronic Injury Surveillance System (NEISS) database. All consecutive patients with a primary injury of fracture in the years 2009 to 2021 were eligible for inclusion in this study. The Cochran-Armitage test was used to assess the trend in fracture-related hospitalization rates over the years studied.
Results
This study showed a significant increase in hospitalizations due to fractures from 2009 to 2021 (p<0.001). This increase in hospitalizations was observed consistently across various factors, including sex, fracture location, age categories, and the pre- and post- COVID-19 pandemic period. From 2009 to 2021, the mean age of patients presenting to EDs was increased from 34 to 40 (p<0.001) and the percentage of women increased from 45% to 48%. There was a significant increase in hospitalizations across five fracture regions including the upper trunk, proximal and distal upper extremity, and proximal and distal lower extremity.
Conclusions
Our findings show hospitalization trends due to fractures have been increasing across the U.S. While reasons for this increased trend are multifactorial, increased utilization of urgent care for less severe injuries may be artificially driving these trends.
{"title":"Hospitalization Trends of Fractures Presenting to the Emergency Room From 2009 to 2021","authors":"Jacob Albers, Jeffrey B. Brown, Maykel Dolorit, Lauren Ladehoff, Ambuj Kumar, Robert P. Wessel","doi":"10.55576/job.v3i4.46","DOIUrl":"https://doi.org/10.55576/job.v3i4.46","url":null,"abstract":"Purpose
 Assessing trends in hospitalization rates due to fractures may be used as an indirect epidemiologic metric to predict future patient volumes, staffing needs, revenue, expenditures, and allocation of resources. The aim of this study is to analyze the trend of hospitalizations for patients who presented to Emergency Departments (EDs) with fractures from 2009 to 2021.
 Methods
 We extracted data from the National Electronic Injury Surveillance System (NEISS) database. All consecutive patients with a primary injury of fracture in the years 2009 to 2021 were eligible for inclusion in this study. The Cochran-Armitage test was used to assess the trend in fracture-related hospitalization rates over the years studied.
 Results
 This study showed a significant increase in hospitalizations due to fractures from 2009 to 2021 (p<0.001). This increase in hospitalizations was observed consistently across various factors, including sex, fracture location, age categories, and the pre- and post- COVID-19 pandemic period. From 2009 to 2021, the mean age of patients presenting to EDs was increased from 34 to 40 (p<0.001) and the percentage of women increased from 45% to 48%. There was a significant increase in hospitalizations across five fracture regions including the upper trunk, proximal and distal upper extremity, and proximal and distal lower extremity.
 Conclusions
 Our findings show hospitalization trends due to fractures have been increasing across the U.S. While reasons for this increased trend are multifactorial, increased utilization of urgent care for less severe injuries may be artificially driving these trends.","PeriodicalId":484349,"journal":{"name":"Journal of orthopaedic business","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135406961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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