Costs and 30-day readmission after lower limb fractures from motorcycle crashes in Queensland,Australia: A linked data analysis |
| |
| Affiliation: | 1. Department of Intensive Care Medicine, Royal Brisbane and Women''s Hospital, Herston, Australia;2. School of Medicine, University of Queensland, Brisbane, Australia;3. College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Australia;4. Jamieson Trauma Institute, Metro North Health, Herston, Australia;5. Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia;6. Queensland Ambulance Service, Department of Health, Brisbane, Australia;7. Department of Orthopaedic Surgery, Princess Alexandria Hospital, Brisbane, Australia;1. The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW 2042, Australia;2. NSW Institute for Trauma and Injury Management (ITIM), NSW Agency for Clinical Innovation (ACI), Locked Bag 2030, St Leonards, NSW 159, Australia;3. Sydney Medical School, University of Sydney, Edward Ford Building (A27) Fisher Road, University of Sydney, NSW 2006, Australia;4. Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, North Ryde, NSW 2109, Australia;5. Department of Traumatology, John Hunter Hospital and School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia;6. Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Susan Wakil Health Building, Western Avenue, The University of Sydney, NSW 2006, Australia;7. South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool, BC, NSW 1871, Australia;8. NSW Agency for Clinical Innovation (ACI), Locked Bag 2030, St Leonards, NSW 1590, Australia;9. Centre for Primary Health Care and Equity, University of New South Wales, Level 3, AGSM Building, UNSW Sydney, NSW 2052, Australia;2. DOT - UNIFESP/EPM - Rua Botucatu, 740 -1o. andar, Vila Clementino – SP, Brazil - CEP 04023-062;1. Department of Pediatrics, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;2. Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;3. General Pediatric Surgery, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;1. Department of Orthopaedic Major Trauma Surgery, Orthopaedic post CCT Fellow, Queen Elizabeth University Hospital, 5/6 Gladstone Terrace, Glasgow, Edinburgh EH9 1LX, United Kingdom;2. Consultant Orthopaedic Surgeon, Queen Elizabeth University Hospital, Glasgow, United Kingdom;3. Queen Elizabeth University Hospital, Glasgow, United Kingdom;1. Department of neurosurgery Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;2. Department of pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;4. Department of neurosurgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim hospital;5. Department of anesthesiology, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah,Iran;6. Clinical Research Development Center, Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran;7. Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;8. Wayne State University School of Medicine, Detroit, MI, USA |
| |
| Abstract: | BackgroundLower limb trauma is the most common injury sustained in motorcycle crashes. There are limited data describing this cohort in Australia and limited international data establishing costs due to lower limb trauma following motorcycle crashes.MethodsThis retrospective cohort study utilised administrative hospitalisation data from Queensland, Australia from 2011–2017. Eligible participants included those admitted with a principal diagnosis coded as lower extremity or pelvic fracture following a motorcycle crash (defined as the index admission). Multiply injured motorcyclists where the lower limb injury was not coded as the primary diagnosis (i.e. principal diagnosis was rather coded as head injury, internal organ injures etc.) were not included in the study. Hospitalisation data were also linked to clinical costing data. Logistic regression was used to determine risk factors for 30-day readmission. Costing data were compared between those readmitted and those who weren't, using bootstrapped t-tests and ANVOA.ResultsA total of 3342 patients met eligibility, with the most common lower limb fracture being tibia/fibula fractures (40.8%). 212 participants (6.3%) were readmitted within 30-days of discharge. The following were found to predict readmission: male sex (OR 1.84, 95% CI 1.01–1.94); chronic anaemia (OR 2.19, 95% CI 1.41–3.39); current/ex-smoker (OR 1.60, 95% CI 1.21–2.12); emergency admission (OR 2.77, 95% CI 1.35–5.70) and tibia/fibula fracture type (OR 1.46, 95% CI 1.10-1.94). The most common reasons for readmission were related to ongoing fracture care, infection or post-operative complications. The average hospitalisation cost for the index admission was AU$29,044 (95% CI $27,235-$30,853) with significant differences seen between fracture types. The total hospitalisation cost of readmissions was almost AU$2 million over the study period, with an average cost of $10,977 (95% CI $9,131- $13,059).ConclusionsUnplanned readmissions occur in 6.3% of lower limb fractures sustained in motorcycle crashes. Independent predictors of readmission within 30 days of discharge included male sex, chronic anaemia, smoking status, fracture type and emergency admission. Index admission and readmission hospitalisation costs are substantial and should prompt health services to invest in ways to reduce readmission. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
