The costs of late detection of developmental dysplasia of the hip

2.50
Hdl Handle:
http://hdl.handle.net/11287/593835
Title:
The costs of late detection of developmental dysplasia of the hip
Authors:
Woodacre, Timothy; Dhadwal, A.; Ball, T.; Edwards, C.; Cox, Peter J.
Abstract:
PURPOSE: Debate currently exists regarding the economic viability for screening for developmental dysplasia of the hip in infants. METHODS: A prospective study of infant hip dysplasia over the period of 1998-2008 (36,960 live births) was performed to determine treatment complexity and associated costs of disease detection and hospital treatment, related to the age at presentation and treatment modality. The involved screening programme utilised universal clinical screening of all infants and selective ultrasound screening of at-risk infants. RESULTS: One hundred and seventy-nine infants (4.8/1,000) presented with hip dysplasia. Thirty-four infants presented late (> 3 months of age) and required closed or open reduction. One hundred and forty-five infants presented at < 3 months of age, 14 of whom failed early Pavlik harness treatment. A detailed cost analysis revealed: 131 early presenters with successful management in a Pavlik harness at a cost of pound601/child; 34 late presenters who required surgery (36 hips, 19 closed/17 open reductions, one revision procedure) at a cost of pound4,352/child; and 14 early presenters with failed management in a Pavlik harness requiring more protracted surgery (18 hips, four closed/14 open reductions, seven revision procedures) at a cost of pound7,052/child. CONCLUSIONS: Late detection causes increased treatment complexity and a sevenfold increase in the short-term costs of treatment, compared to early detection and successful management in a Pavlik harness. DISCUSSION: Improved strategies are needed for the 10 % of early presenting infants who fail Pavlik harness treatment and require the most complex and costly interventions.
Citation:
J Child Orthop. 2014 Aug;8(4):325-32.
Publisher:
Springer
Journal:
Journal of children's orthopaedics
Issue Date:
1-Aug-2014
URI:
http://hdl.handle.net/11287/593835
DOI:
10.1007/s11832-014-0599-7
PubMed ID:
24973899
Additional Links:
http://dx.doi.org/10.1007/s11832-014-0599-7
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
1863-2521
Appears in Collections:
General Trauma & Orthopaedics; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorWoodacre, Timothyen
dc.contributor.authorDhadwal, A.en
dc.contributor.authorBall, T.en
dc.contributor.authorEdwards, C.en
dc.contributor.authorCox, Peter J.en
dc.date.accessioned2016-01-19T12:35:33Zen
dc.date.available2016-01-19T12:35:33Zen
dc.date.issued2014-08-01en
dc.identifier.citationJ Child Orthop. 2014 Aug;8(4):325-32.en
dc.identifier.issn1863-2521en
dc.identifier.pmid24973899en
dc.identifier.doi10.1007/s11832-014-0599-7en
dc.identifier.urihttp://hdl.handle.net/11287/593835en
dc.description.abstractPURPOSE: Debate currently exists regarding the economic viability for screening for developmental dysplasia of the hip in infants. METHODS: A prospective study of infant hip dysplasia over the period of 1998-2008 (36,960 live births) was performed to determine treatment complexity and associated costs of disease detection and hospital treatment, related to the age at presentation and treatment modality. The involved screening programme utilised universal clinical screening of all infants and selective ultrasound screening of at-risk infants. RESULTS: One hundred and seventy-nine infants (4.8/1,000) presented with hip dysplasia. Thirty-four infants presented late (> 3 months of age) and required closed or open reduction. One hundred and forty-five infants presented at < 3 months of age, 14 of whom failed early Pavlik harness treatment. A detailed cost analysis revealed: 131 early presenters with successful management in a Pavlik harness at a cost of pound601/child; 34 late presenters who required surgery (36 hips, 19 closed/17 open reductions, one revision procedure) at a cost of pound4,352/child; and 14 early presenters with failed management in a Pavlik harness requiring more protracted surgery (18 hips, four closed/14 open reductions, seven revision procedures) at a cost of pound7,052/child. CONCLUSIONS: Late detection causes increased treatment complexity and a sevenfold increase in the short-term costs of treatment, compared to early detection and successful management in a Pavlik harness. DISCUSSION: Improved strategies are needed for the 10 % of early presenting infants who fail Pavlik harness treatment and require the most complex and costly interventions.en
dc.language.isoengen
dc.publisherSpringeren
dc.relation.urlhttp://dx.doi.org/10.1007/s11832-014-0599-7en
dc.titleThe costs of late detection of developmental dysplasia of the hipen
dc.typeJournal Articleen
dc.identifier.journalJournal of children's orthopaedicsen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en
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