Abstract:
OBJECTIVES:We evaluated the economic aspects of an orthopaedic trauma section at a regional Level I, semi-academic community hospital. This study analyzes the economics of a dedicated hospital-based orthopaedic trauma program. METHODS:Institutional financial reports were analyzed for 2 time periods. In the pre-program (PRE) period (2 years), we estimated the amount of forsaken revenue resulting from cases transferred to other institutions. In the post-program (POST) period (2 years), we analyzed financial reports to evaluate fiscal solvency. Health Care Cost and Utilization Project National Inpatient Sample (HCUP-NIS) data, International Classification of Diseases, 9th Revision (ICD-90 codes, and Eclipsys software were used. Standard accounting definitions for gross revenue, net revenue, direct costs, contribution margin, indirect costs, and net profit/loss were used. RESULTS:In the PRE-program period 88 patients were transferred; forsaken charges were about $1.25 million/year. Based on historic collection rates, there was about $450,000/year of actual lost revenue. In the POST-program period net revenue was about $7 million with a $1.5 million contribution margin, which increased 9%-11% in year 2. With inclusion of indirect costs, there was a net loss of nearly $5 million/year, but the financial software uses the direct cost expense as a major determinant of indirect costs. Based on the definition of indirect costs (overhead for lights, maintenance, etc) and with such expenses being used prior to the program, we felt that indirect cost was not an accurate variable and contribution margin is the better measure of economic value. CONCLUSION:We found that orthopaedic trauma is a financially viable program. Understanding the determination and interpretation of financial data is essential for any such analysis.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Ziran BH,Barrette-Grischow MK,Marucci Kdoi
10.1097/BOT.0b013e31816bae67subject
Has Abstractpub_date
2008-04-01 00:00:00pages
227-33issue
4eissn
0890-5339issn
1531-2291pii
00005131-200804000-00004journal_volume
22pub_type
杂志文章abstract:OBJECTIVE:To report the results from functional bracing of isolated ulnar shaft fractures. DESIGN:Retrospective review. SETTING:Two university hospitals. PATIENTS:Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. INTERVENTION:Prefa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00
abstract::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000004
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:To compare postoperative pain control in patients treated surgically for ankle fractures who receive popliteal blocks with those who received general anesthesia alone. DESIGN:Institutional Review Board approved prospective randomized study. SETTING:Metropolitan tertiary-care referral center. PATIENTS:All ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e3182638b25
更新日期:2012-10-01 00:00:00
abstract::Studies in several countries have indicated that there is likely to be a dramatic increase in the number of hip fractures in the early part of the 21st century. At a time when health care costs are coming under close scrutiny internationally, the added financial burden of the increasing number of fractures is of conce...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair. DESIGN:This was an institutional review board-approved retrospective review of prospectively collected data. SETTING:The study was conducted at an Academ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182539333
更新日期:2013-03-01 00:00:00
abstract::To evaluate the biomechanical and clinical results of modified separate vertical wiring technique (SVW) for inferior pole patellar fracture repair we conducted a finite element biomechanical study using 2 fixation methods and evaluated a clinical series of eleven patients. The modified SVW technique was an effective, ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001080
更新日期:2018-04-01 00:00:00
abstract::A study was undertaken to review the results of donor site morbidity of cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred six patients who underwent 230 proximal tibial bone graft harvestings were reviewed. Patients with lower-extremity fractures or nonunions who required cancellous bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199112000-00014
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures. DESIGN:Retrospective cohort study. Data was collected from medical records and radiographs. SETTING:Two level-1 trauma centers. PATIENTS/PARTICIPANTS:Patients who sustained an open tibial frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31824133e3
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To analyze the mechanical stability of locked plating in comparison with tension-band wiring for the fixation of fractures of the patella. METHODS:Biomechanical tests were performed on artificial foam patella specimens comparing an angular stable plate and monocortical screws with tension-band wiring. Tests ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000309
更新日期:2015-09-01 00:00:00
abstract::Prospectively, 40 patients with an average age of 45 (20-65) with closed transverse fractures of the middle one-third of the humerus without associated radial nerve palsy were treated. All had failed nonoperative reduction and were then operated on with either compression plating or intramedullary fixation with Hacket...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199506000-00003
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate the frequency of intraoperative problems and complications involved with Less Invasive Stabilization System (LISS) plate removal. DESIGN:Retrospective study. SETTING:Single academic level I trauma center. METHODS:Medical records were reviewed for demographics, surgical ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c29bf5
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. DESIGN:Retrospective review. SETTING:Urban level 1 academic trauma center. PATIENTS:A total of 307 (226 men/8...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000346
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318172841c
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the incidence of unplanned reoperations after pelvic ring injuries and to develop a risk prediction model. DESIGN:Retrospective review. SETTING:Level I Trauma Center. PATIENTS:The medical records of 913 patients (644 male and 269 female patients; mean age, 39 years; age range, 16-89 years) wit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001170
更新日期:2018-07-01 00:00:00
abstract::Segmental defects of the tibia present a challenging problem. This report demonstrates the use of an ipsilateral vascularized fibula transfer (IVFT) in a patient with a 15 cm tibial bone defect following tumor resection. Bone union was achieved within 6 months, and 8 years after the surgery the patient has full knee f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3180330927
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:To report the safety and clinical outcomes of placing current magnetic resonance imaging (MRI) components inside and outside the MRI bore during MRIs. DESIGN:Retrospective case series. SETTING:Four trauma centers (3 Level I and 1 Level II), from January 2005 to January 2015. PATIENTS:All patients who had ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000954
更新日期:2017-11-01 00:00:00
abstract::Marginal impaction of the acetabulum is typically accessible through fracture planes specific to the nature of the injury. Infrequently, however, incarcerated marginal impaction or free osteochondral fragments are not accessible through these existing fracture planes. As such, alternative methods to access these artic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000759
更新日期:2017-05-01 00:00:00
abstract::The technique of lengthening over an antegrade nail is used widely for distraction osteogenesis of the femur. Most reported complications of this technique are related to Schanz pins. We hypothesized that reducing the number of Schanz pins would enable successful distraction with fewer complications. To this purpose, ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31824a3e66
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair. DESIGN:Retrospective case series. SETTING:University-affiliated regional trauma center. PATIENT/PARTICIPANTS:Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an add...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181847a42
更新日期:2008-09-01 00:00:00
abstract::Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We hypothesize that ant...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200607000-00011
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. SETTING:Universi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200303000-00007
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:Far cortical locking (FCL) constructs have been shown to increase axial interfragmentary displacement while limiting shear and have been specifically recommended in the treatment of distal femur fractures. However, there is no available data regarding their mechanical behavior within the range of bridge span...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001341
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. DESIGN:: Prospective clinical series study. SETTING:University hospital. PATIENTS:Twenty-one patients with acut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318254895f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To observe and report the clinical results of indirect reduction and plating in the treatment of distal femoral nonunions. DESIGN:Prospective consecutive study. SETTING:Regional trauma center. PATIENTS:A consecutive series of twenty patients with nonunion of the distal femur, nineteen of whom had undergone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200205000-00001
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:To compare the outcomes of two different surgical treatments for the management of isolated closed Mason Type 2 radial head fractures. DESIGN:Retrospective study. The Student t test and McPearson chi-square test were used to evaluate whether there was a significance difference between the groups. PATIENTS:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318220a227
更新日期:2012-04-01 00:00:00
abstract:SUMMARY:Convergent type radioulnar translocation is an extremely rare form of injury occurring in a growing child. We report a case of convergent radioulnar translocation along with a radial head fracture in a young child. Open reduction of the elbow and internal fixation of the radial head fragment helped in achieving...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31821d7fd5
更新日期:2012-04-01 00:00:00
abstract::Healing patterns were compared between transverse and 60 degrees oblique osteotomies in canine tibiae stabilized under external fixation. Under similar in vitro testing conditions (osteotomy ends in contact), the axial stiffness of the oblique osteotomy under external fixation was 45% of the paired transverse osteotom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199109000-00016
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract::Not all fractures heal well or rapidly in the adult skeleton, and basic scientists and clinicians continue to search for ways to make fractures heal more predictably. It is a fundamental tenet of orthopaedics that skeletal injury is followed by inflammation and that this inflammatory response is the first stage in a s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181f17b33
更新日期:2010-09-01 00:00:00