title: A microcosting study of the surgical correction of upper extremity deformity in children with spastic cerebral palsy.
abstract: OBJECTIVE
  Determine healthcare costs of upper-extremity surgical correction in children with spastic cerebral palsy (CP).
  
  
  METHODS
  This cohort study included 39 children with spastic CP who had surgery for their upper extremity at a Dutch hospital. A retrospective cost analysis was performed including both hospital and rehabilitation costs. Hospital costs were determined using microcosting methodology. Rehabilitation costs were estimated using reference prices.
  
  
  RESULTS
  Hospital costs averaged €6813 per child. Labor (50%), overheads (29%), and medical aids (15%) were important cost drivers. Rehabilitation costs were estimated at €3599 per child.
  
  
  CONCLUSIONS
  Surgery of the upper extremity is an important contributor to the healthcare costs of children with CP. Our study shows that labor is the most important cost driver for hospital costs, owing to the multidisciplinary approach and patient-specific treatment plan. A remarkable finding was the substantial amount of rehabilitation costs.
authors.affiliation: a Department of Plastic, Reconstructive and Hand Surgery , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Juul Vera
authors.initials: JV
authors.lastname: Alewijnse
authors.affiliation: b Institute for Medical Technology Assessment, Erasmus University Rotterdam , Rotterdam , The Netherlands.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: van Rooijen
authors.affiliation: a Department of Plastic, Reconstructive and Hand Surgery , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Mick
authors.initials: M
authors.lastname: Kreulen
authors.affiliation: a Department of Plastic, Reconstructive and Hand Surgery , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Mark Jc
authors.initials: MJ
authors.lastname: Smeulders
authors.affiliation: b Institute for Medical Technology Assessment, Erasmus University Rotterdam , Rotterdam , The Netherlands.
authors.forename: Siok Swan
authors.initials: SS
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000191:economics* / Q000601:surgery*; D002648:Child; D003365:Costs and Cost Analysis / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D034941:Upper Extremity / Q000601:surgery*
keywords: Cerebral palsy; cost analysis; microcosting; surgery; upper-extremity deformity