Cost-reduction Analysis of Percutaneous Pinning of Hand Fractures in an Outpatient Clinic.

Background: The University of Sherbrooke's Hospital Center operating room has been affected by the COVID-19 pandemic, prompting surgeons to seek alternative ways to treat acute injuries requiring surgery. In the spring of 2020, we began performing percutaneous pinning of hand fractures in our outpatient clinic. We aimed to estimate the savings in 2021 by transferring these procedures from the operating room to the outpatient clinic. Methods: We identified all patients with hand injuries who received percutaneous pinning in 2021 using billing codes. Only patients treated in the outpatient clinic were included. We estimated the cost of hand fracture fixation in the operating room by considering the anesthesiologist's fee, the hospital's hourly rate for a 1-hour surgery (including a respiratory therapist, 2 nurses, and equipment) and salary bonuses for unfavorable hours, subtracting the cost difference of outpatient equipment. Results: We identified 114 patients treated with percutaneous pinning, of whom 93 were included in our study. Our calculations showed a total cost reduction of CAD $55,789 in 2021. Conclusions: Percutaneous pinning of hand fractures in an outpatient setting resulted in a yearly cost reduction of more than CAD $55,000. Investing in ambulatory care for hand fracture management benefits both patients and institutions.