Cost-effectiveness of replacing versus discarding the nail in children with nail bed injury
Author:
Dakin Helen A1ORCID, Nguyen Thi Thu An2, Dritsaki Melina34, Greig Aina V H5, Stokes Jamie R3, Cook Jonathan A3ORCID, Beard David J3ORCID, Davies Loretta3, Gardiner Matthew D36ORCID, Jain Abhilash37, Png M E, Jones A, Cooper C, Sierakowski A, Mertic A, Gerrish H, Cranmer K, Fox N, Dutta P, Vissers G, Costa P, Irri R, McArthur G, Horwitz M, Sleiwah A, Jephson H, Deeley M, Nicholas R, Vinnicombe Z, Nicola A, Chuo C Bing, Milner C, Heaney J, Totty J, Fleet M, Faheem Khadim M, Williams P, Bibawy S, Round A, Pinder R, Plonczak A, Lawton G, Kennedy D, Bennett A, Fadulelmola A, James J, Reay E, Beadon K, Cameron T, Oliver Z, Wensley K, Dupré S, Rodriguez J, Furniss D, Gale M, Knight A, Tulip J, Turner L, Wellings L, Allen M, Wade R, Itte V, Bourke G, Kumar N, O'Sullivan S, Jones J WM, Young K, Taylor K, Dawood O, Booth S, Giwa L, Pearl R, Coutts A, Hawkins R, Mostafa A, Nisbett T, Riddlestone P, Selby A, Uzoho C, Chasiouras D, Bainbridge LC, Buick T, Lam W, Baker B, Walsh K, Keating K, Dalan R, Shah M, Mead D, Diment S, Nicolau M, Smeeton B, Thomson D, Senior N, Moledina J, Colville J, Manso K, Song M, Manley O, Drury P, Kerstein R, Cobb W, Wormald J, Shirley R, Tan A, Arnaout A, Cruz C, Brice N, Segaren N, Joji N, Chawla R, Hassanin S, Adami R, Ridha H, Cook A, Symington L, Long R, Dustagheer S, Jarvis H, Larsen M, Williams M, Trickett R, Miles D, Pai A, Honeywell C, Brady C, Madhavan S, Manou V, Phillips G, Baker R,
Affiliation:
1. Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford , Oxford , UK 2. Department of Economics and Related Studies, University of York , York , UK 3. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK 4. Department of Economics and Laboratory of Applied Economics, University of Western Macedonia , Kastoria , Greece 5. Department of Plastic and Reconstructive Surgery, Guy’s and St Thomas’ NHS Foundation Trust , London , UK 6. Department of Plastic Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust , Slough , UK 7. Department of Plastic Surgery, Imperial College NHS Healthcare Trust London , London , UK
Abstract
Lay Summary
Every year in the UK, around 10 000 children need to have operations to mend injuries to the bed of their fingernails. Currently, most children have their fingernail placed back on the injured nail bed after the operation. The NINJA trial found that children were slightly less likely to have an infection if the nail was thrown away rather than being put back, but the difference between groups was small and could have be due to chance. This study looked at whether replacing the nail is cost-effective compared with throwing it away. Using data from the NINJA trial, we compared costs, healthcare use, and quality of life and assessed the cost-effectiveness of replacing the nail. It was found that throwing the nail away after surgery would save the National Health Service (NHS) £75 (€85) per operation compared with placing the nail back on the nail bed. Changing clinical practice could save the NHS in England £720 000 (€819 000) per year.
Funder
National Institute for Health Research Royal College of Surgeons of England Department of Health and Social Care
Publisher
Oxford University Press (OUP)
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