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[Direct cost assessment of wrist fractures].

PURPOSE OF THE STUDY
The cost effectiveness of wrist fractures in 1996 at Pitié-Salpétrière Hospital in Paris has been thoroughly analysed. The purpose of this retrospective study was to identify the factors responsible for the variation in the treatment cost of those fractures.


MATERIAL AND METHODS
Cost, hospital stay, functional status, ASA score and surgical treatment were analysed in 53 patients with a median age of 57 years.


RESULTS
The mean cost per patient was 6,120 FF divided as follows: 26.1% for pre-operative care, 36.4% for surgical procedures, 37.5% for post-operative care. The mean hospital stay was 4.3 days. The cost of personnel (43%) and medical investigations (35%) were the two main sources of hospital expenses beside medical materials (12.5%), hostelry (5.5%), and drugs (4%).


DISCUSSION
The duration of hospital stay, the age and the type of the fracture were the only factors that affected statistically the mean cost per patient. Furthermore, factors related to the patient as sex, place of residence prior to admission, functional status, ASA score, had no influence on cost variation.


CONCLUSION
Therefore, the best way to reduce the cost of wrist fractures management is to minimize the hospital stay before and after surgical procedure to avoid a lengthy and costly hospital stay and to minimize the abuse utilisation of systematic medical investigations.