title: Resource utilization in clubfoot management.
abstract: Both private and socialized healthcare systems require treatments to be not only effective, but also cost-efficient. Although the Ponseti method of clubfoot treatment is effective, its cost-effectiveness has not been demonstrated. We compared the difference in resource use between two prospective cohorts treated for clubfoot by either the Ponseti method or below-knee casting followed by primary surgical release in the socialized healthcare system of New Zealand. Using these cohorts and US billing data, costs of treating these cohorts in the US healthcare system were also calculated. Treatment of initial deformity, recurrences, and complications in both cohorts were included in the final assessment. Twenty-six patients (40 feet) were enrolled in the Ponseti cohort and 29 (46 feet) in the primary surgical cohort. For most patients, the Ponseti method was more cost-effective than the primary surgical treatment in both healthcare systems. The cost of treating both cohorts was lower in the socialized system than in the US healthcare system.
  
  
  METHODS
  Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Helen DeVos Children's Hospital, 1425 Michigan Street NE, Suite D, Grand Rapids, MI 49503, USA. matthew.halanski@devoschildrens.org
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Halanski
authors.forename: Jen-Chen
authors.initials: JC
authors.lastname: Huang
authors.forename: Stewart J
authors.initials: SJ
authors.lastname: Walsh
authors.forename: Haemish A
authors.initials: HA
authors.lastname: Crawford
mesh_terms: D002370:Casts, Surgical / Q000706:statistics & numerical data; D003025:Clubfoot / Q000191:economics / Q000628:therapy*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data; D026201:Musculoskeletal Manipulations / Q000191:economics / Q000706:statistics & numerical data*; D009520:New Zealand; D019637:Orthopedic Procedures / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013710:Tendons / Q000601:surgery; D016896:Treatment Outcome