Description and cost‐analysis of emergency department attendances for hand and wrist injuries

Abstract

Background Injuries to the hand and wrist are estimated to account for between 10% and 30% of all ED presentations. The economic burden placed on the healthcare system can be extensive and rise sharply with increase in injury severity. Objectives This cost‐analysis was performed with the aim of estimating the economic implications of ED attendances for hand and wrist injuries from the perspective of one Australian public health network. Methods Data from two EDs were retrieved from the electronic billing records of one large health network across two financial year periods (2014–2015 and 2015–2016) using ICD‐10 codes. All costs that resulted from the treatment of any acute hand or wrist injury across the 2 year period were calculated and are presented by age, sex, injury type and mechanism of injury. Results A total of 10 024 individuals presented to the two EDs in the 2 year period, accounting for approximately 5.4% of all presentations. The most common presentations were males (62.2%), people aged 25–34 years (26.9%) and lacerations (31.2%). The total cost in the 2 year study period was $3 959 535.38 ($1 923 852.38 in 2014–2015; $2 035 683.00 in 2015–2016). The mean cost per presentation was $383 (95% CI [$373, $393]) in 2014–2015 and $407 (95% CI [$394, $421]) in 2015–2016. Conclusions Acute hand and wrist injuries contribute to a significant volume of ED presentations each year in one Australian public health network leading to significant expenditure and health resources. Further research into how to best utilise resources and reduce avoidable injuries should be priority areas to reduce the cost of these injuries to the healthcare system and society.

Retrospective Analysis of Patients with Isolated Hand Injuries Admitted to the Emergency Department

“…In addition, they reported an average recovery time of 13 weeks before the patient can start working again after a finger loss (20). Furthermore, direct and indirect costs resulting from hand injuries adversely affect healthcare costs (21). Therefore, it is important to identify injuries and risk factors resulting in an amputation or permanent disability.…”

Axilla nerve block in the emergency department

“…Australian EDs have about 8 million presentations a year with 10–30% of these being injuries to the upper limb, predominantly the hand and wrist 1,2 . These upper limb injuries are significant for ED workloads, especially in rural and remote centres 3 . The axilla nerve block (ANB) is versatile and covers injuries from the elbow to the hand, such as wrist fracture reductions, and may be an option to improve patient care, reduce both length of stay and resource allocation.…”

A population-based study of the direct longitudinal health care costs of upper extremity trauma in patients aged 18–65 years

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Upper extremity (UE) trauma -specifically, hand and wrist trauma -is a substantial public health issue representing a common presentation to the emergency department. [1][2][3][4][5][6][7] Injuries at different levels in the UE affect hand and wrist function and include wounds and vascular, nerve and musculoskeletal injuries. The frequency of these injuries is increasing secondary to population growth and aging and associated with rising health care costs for acute and ongoing care.

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“…3 Large volumes of UE trauma have the potential to create a sizable impact on the health care system. Although existing data report the health system cost of acute trauma care for UE, [1][2][3]6 little is known about longitudinal health care costs.Longitudinal cost estimates of UE trauma provide evidence for hospital administrators, policy decision-makers and researchers assessing novel prevention strategies and care pathway models. The primary objective of this populationbased study was to determine the attributable long-term direct health care costs and utilization after UE trauma that required acute surgical intervention, with a specific emphasis on hand, wrist and UE peripheral nerve injuries.…”

“…3 Large volumes of UE trauma have the potential to create a sizable impact on the health care system. Although existing data report the health system cost of acute trauma care for UE, [1][2][3]6 little is known about longitudinal health care costs.…”