title: Impact on costs of switching one-ray aponeurectomy to percutaneous needle aponeurotomy in Dupuytren's disease: A model analysis.
abstract: OBJECTIVE
  To assess the cost of switching surgical aponeurectomy to percutaneous needle aponeurotomy in one-ray Dupuytren's disease.
  
  
  METHODS
  A model analysis was performed with a cross-sectional national survey of public and private French hospitals in 2012. All stays for one-ray aponeurectomy were "virtually" replaced with 1, 2 or 3 outpatient sessions of percutaneous needle aponeurotomy. The costs were based on the hospital cost (tariff per disease-related group) and on common classification of medical procedures performed in outpatient care for 2013.
  
  
  RESULTS
  Dupuytren's disease represented 18,707 hospitalizations (€26 million [2013 euros]) in France in 2012, 8534 hospitalizations for one-ray aponeurectomy (€11.9 million). By replacing surgical aponeurectomy with percutaneous needle aponeurotomy for one-ray Dupuytren's disease, 91% to 97% and 56% to 59% of the treatment costs could be saved using hospitalizations for one-ray aponeurectomy or total hospital costs, respectively, as reference.
  
  
  CONCLUSIONS
  Replacing aponeurectomy with percutaneous needle aponeurotomy for one-ray Dupuytren's disease could greatly reduce the treatment costs for all Dupuytren's disease. Effective alternatives to surgery for Dupuytren's disease, such as needle aponeurotomy in an outpatient setting should be considered in the economic perspective.
authors: Service de rhumatologie, hôpital Lariboisière, université Paris 7, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: mmaravic2010@gmail.com.
authors: Milka
authors: M
authors: Maravic
authors: Service de rhumatologie, hôpital Lariboisière, université Paris 7, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors: Johann
authors: J
authors: Beaudreuil
mesh_terms: D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004387:Dupuytren Contracture / Q000191:economics / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005602:France; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009339:Needles; D019637:Orthopedic Procedures / Q000295:instrumentation*
keywords: Aponeurectomy; Costs; Dupuytren's disease; Hospitalization; Needle aponeurotomy