A Comparison of the Costs of Managing Proximal Humerus Fractures in a Cohort of Patients Injured in Road Traffic Incidents Under the Transport Accident Commission Scheme in the State of Victoria.

backgroundProximal humerus fractures are becoming more prevalent with associated increases in operative management. This study aimed to compare costs between operative and non-operative management of these fractures in an Australian population.

methodsA cost-analysis was performed in a cohort of patients initially managed at a Level 1 Trauma Centre between January 2010 and December 2018, who sustained a proximal humerus fracture following a road traffic injury. Patients were identified using ICD-10-AM coding and matched to the Victorian Orthopaedic Trauma Outcome Registry. This cohort was linked with data from the state's no-fault third-party insurer for transport injuries to obtain total claims cost data for the acute admission, subsequent admissions, and rehabilitation costs in Australian dollars.

resultsA total of 113 patients met the inclusion criteria; 31 non-operative and 81 operative. The mean (SD) age was 50.1 (20.3) years in the non-operative group and 44.0 (15.8) in the operative group (p = 0.10). In the non-operative group, 87% of patients sustained other injuries compared with 76% of patients in the operative group (p = 0.30). The median total treatment cost in the non-operative group was A$48 982 compared to A$36 457 in the operative group (p = 0.99). Median subsequent admission costs for the respective groups were A$9 643 and A$8 378 (p = 0.77) and median rehabilitation costs were A$6 016 and A$4 754 respectively (p = 0.95).

conclusionHealthcare associated costs did not differ significantly in trauma patients with proximal humerus fractures regardless of management undertaken. Concerns regarding healthcare costs should not impact on surgical decision-making when managing these fractures.