Evidence map›Paper›PMID 35245987›Full record

ArticleHand (New York, N.Y.)2022

Charges for Distal Radius Fracture Fixation Are Affected by Fracture Pattern, Location of Service, and Anesthesia Type.

Avi D Goodman, Peter Brodeur, Aristides I Cruz, Lindsay R Kosinski, Edward Akelman, Joseph A Gil

Abstract read
In one paragraph

Article in Hand (New York, N.Y.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Avi D GoodmanBrigham and Women's Hospital, Boston, MA, USA.ORCID 0000-0001-8665-8257
Peter BrodeurBrown University, Providence, RI, USA.ORCID 0000-0002-7391-719X
Aristides I CruzBrown University and Rhode Island Hospital, Providence, RI, USA.
Lindsay R KosinskiBrown University and Rhode Island Hospital, Providence, RI, USA.ORCID 0000-0002-8586-7089
Edward AkelmanBrown University and Rhode Island Hospital, Providence, RI, USA.
Joseph A GilBrown University and Rhode Island Hospital, Providence, RI, USA.ORCID 0000-0002-0117-1026

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study sought to characterize charges associated with operative treatment of distal radius fractures and identify sources of variation contributing to overall cost.

methodsA retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009-2017. Outpatient claims were identified using the International Classification of Diseases-9/10-Clinical Modification diagnosis codes for distal radius fixation surgery. A multivariable mixed model regression was performed to identify variables contributing to total charges of the claim, including patient demographics, anesthesia method, surgery location (ambulatory surgery center [ASC] versus a hospital outpatient department [HOPD], operation time, insurance type, Charlson Comorbidity Index, and billed procedure codes.

resultsA total of 9029 claims were included, finding older age, private primary insurance, surgery performed in a HOPD, and use of local anesthesia (vs general or regional) associated with increased total charges. There was no difference between gender, race, or ethnicity. Additionally, open reduction and internal fixation (ORIF), increased operative time/fracture complexity, and use of perioperative medications contributed significantly to overall costs.

conclusionsCharges for distal radius fracture surgery performed in a HOPD were 28.3% higher than compared to an ASC, and cases with local anesthesia had higher billed claims compared to regional or general anesthesia. Furthermore, charges for percutaneous fixation were 54.6% lower than ORIF of extraarticular fracture, and claims had substantial geographic variation. These findings may be used by providers and payers to help improve value of distal radius fracture care. LEVEL OF EVIDENCE: Level III.

Indexed as

Radius FracturesWrist FracturesAnesthesia, LocalHumansRetrospective StudiesTreatment Outcomecostfactorsfixationfractureradius

Identifiers

PMID35245987
PMCPMC9793609

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.