2022, Number 1
Direct medical cost of late rehabilitation in workers with conservatively managed proximal humerus fracture
Language: Spanish
References: 14
Page: 14-19
PDF size: 130.21 Kb.
ABSTRACT
Introduction: Eighty percent of the Proximal humerus fractures are not displaced or minimally displaced and stable. The international treatment recommendation is conservative. Immobilization of the limb carries risk of stiffness, pain and decreased function. Currently being used rehabilitation programs with early mobilization of the injured shoulder within the first week post-fracture, with evidence of early functional and labor recovery and with no risk for displacement of fragments. However, in our country, these patients start rehabilitation late, which leads to a delay in the recovery of functionality and delay in returning to work, translating into increased costs. At the moment there is no national benchmark for the cost of this late-onset rehabilitation. Material and methods: From a non-probabilistic sample for convenience, were analyzed records of 52 patients, treated in the period from January to December 2019. Inclusion criteria were workers diagnosed with a proximal humeral fracture, conservative management; exclusion criteria were peripheral nerve injury, aggregate fracture or surgically treated. Results: The mean direct medical cost was $19,090.69 Mexican pesos, directly proportional to the days of stay in the unit and disability. Conclusion: Late rehabilitation leads to more days of disability than recommended by the based guidelinesin the workload, therefore, higher cost.REFERENCES
Handoll H, Brealey S, Rangan A, Keding A, Corbacho B, Jefferson L, et al. The ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation) trial - a pragmatic multicentre randomised controlled trial evaluating the clinical effectiveness and cost-effectiveness of surgical compared with non-surgical treatment for proximal fracture of the humerus in adults. Health Technol Assess. 2015; 19(24): 1-280.
Aguado HJ, Ariño B, Moreno-mateo F, Bustinza EY, Simón-pérez C, Martínez-Zarzuela M, et al. Does an early mobilization and immediate home- based self-therapy exercise program displace proximal humeral fractures in conservative treatment? Observational study. J Shoulder Elb Surg. 2018; 27 (11): 2021-9. Available in: https://doi.org/10.1016/j.jse.2018.04.001
EVIDENCE LEVEL
IV