Cost minimisation using clinic-based treatment for common hand conditions--a prospective economic analysis.
BACKGROUND
The purpose of this study was to compare the cost of treatment of Dupuytren's disease, ganglia and trigger digits in the out-patient department with the operating theatre.


METHODS
All patients seen in a new patient hand clinic with a diagnosis of Dupuytren's disease, trigger digit or ganglion of the wrist or hand requiring treatment were prospectively identified over a 6-month period. The numbers undergoing a procedure in the out-patient clinic or theatre were recorded. Costings of theatre time and out-patient time, as well as national tariff income, were obtained from the hospital management.


RESULTS
Over the 6-month period, 80, 26, and 52 patients were treated with regard to Dupuytren's disease, ganglia and trigger digits, respectively. Of these, 37, 23, and 44 were treated by an out-patient procedure, and 43, 3 and 8 underwent a formal operation. The total cost of the out-patient procedures was calculated at pound 1560 over 6 months. To perform these as formal operations would have cost pound 64,896. The cost savings were, therefore, pound 63,336, or pound 126,672 per annum.


CONCLUSIONS
Out-patient interventions for Dupuytren's disease, ganglia and trigger digits result in significant cost savings over formal surgical treatment.
Webb
J A
JA
Department of Trauma & Orthopaedics, James Cook University Hospital, Middlesbrough, UK. jameswebb@doctors.net.uk
Stothard
J
J
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics*; D002648:Child; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004387:Dupuytren Contracture / Q000191:economics* / Q000601:surgery; D004739:England; D045888:Ganglion Cysts / Q000191:economics* / Q000601:surgery; D006225:Hand / Q000601:surgery*; D006801:Humans; D011446:Prospective Studies; D052582:Trigger Finger Disorder / Q000191:economics* / Q000601:surgery