Cost minimization analysis of the treatment of distal radial fractures in the elderly.
AIMS
The aim of this study was to test the null hypothesis that there is no difference, from the payer perspective, in the cost of treatment of a distal radial fracture in an elderly patient, aged > 65 years, between open reduction and internal fixation (ORIF) and closed reduction (CR).


MATERIALS AND METHODS
Data relating to the treatment of these injuries in the elderly between January 2007 and December 2015 were extracted using the Humana and Medicare Advantage Databases. The primary outcome of interest was the cost associated with treatment. Secondary analysis included the cost of common complications. Statistical analysis was performed using a non-parametric t-test and chi-squared test.


RESULTS
Our search yielded 8924 patients treated with ORIF and 5629 patients treated with CR. The mean cost of an uncomplicated ORIF was more than a CR ($7749 versus $2161). The mean additional cost of a complication in the ORIF group was greater than in the CR group ($1853 versus $1362).


CONCLUSION
These findings show that there are greater payer fees associated with ORIF than CR in patients aged > 65 years with a distal radial fracture. CR may be a higher-value intervention in these patients. Cite this article: Bone Joint J 2018;100-B:205-11.
['Pang|E Q|EQ|', 'Truntzer|J|J|', 'Baker|L|L|', 'Harris|A H S|AHS|', 'Gardner|M J|MJ|', 'Kamal|R N|RN|']
D000368:Aged D000369:Aged, 80 and over D003363:Cost Control D005260:Female D005592:Fracture Fixation D006801:Humans D008297:Male D011183:Postoperative Complications D011885:Radius Fractures D014481:United States
Cost minimization Distal radial fracture Elderly Cost analysis Distal radius