Association between the Orthopaedic Trauma Society classification of open fractures and economic costs

Author:

Png May Ee1,Petrou Stavros1,Bourget-Murray Jonathan2ORCID,Knight Ruth3ORCID,Trompeter Alex J.4ORCID,Costa Matt L.5

Affiliation:

1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

2. Oxford Trauma Unit, John Radcliffe Hospital, Oxford University Hospital, Oxford, UK

3. Centre for Statistics in Medicine, Oxford Clinical Trials Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

4. Orthopaedic Trauma and Limb Reconstruction Unit, St George's University Hospital, London, UK

5. Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK

Abstract

Aims The aim of this study was to investigate the relationship between the Orthopaedic Trauma Society (OTS) classification of open fractures and economic costs. Methods Resource use was measured during the six months that followed open fractures of the lower limb in 748 adults recruited as part of two large clinical trials within the UK Major Trauma Research Network. Resource inputs were valued using unit costs drawn from primary and secondary sources. Economic costs (GBP sterling, 2017 to 2018 prices), estimated from both a NHS and Personal Social Services (PSS) perspective, were related to the degree of complexity of the open fracture based on the OTS classification. Results Adjusted mean total NHS and PSS costs were £13,785 following treatment of complex fractures and £3,550 following treatment of simple fractures, where the open fracture wound is closed at the end of the first wound debridement, generating a mean difference of £10,235 (95% confidence interval £8,074 to £12,396). Conclusion Following previous work correlating clinical outcomes with the OTS classification of open fractures, this study suggests that the new OTS classification also correlates with economic costs estimated from alternative study perspectives. Cite this article: Bone Joint J 2022;104-B(3):408–412.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

Reference22 articles.

1. The Orthopaedic Trauma Society classification of open fractures

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3. EuroQol: the current state of play

4. No authors listed. OECD Health Statistics 2021. Organisation for Economic Cooperation and Development. 2021. http://www.oecd.org/els/health-systems/health-data.htm (date last accessed 2 February 2022).

5. No authors listed. Major trauma care in England. National Audit Office. https://www.nao.org.uk/report/major-trauma-care-in-england/ (date last accessed 2 February 2022).

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