Abstract: Cost Analysis of Percutaneous Fixation of Hand Fractures in the Main Operating Room Versus the Ambulatory Setting
Bibliographic record
Abstract
INTRODUCTION: To date, there have been no studies identifying the cost differential for performing closed reduction internal fixation (CRIF) of hand fractures in the operating room (OR) versus an outpatient clinic setting. Our goal was to analyze the cost and efficiency of performing CRIF in these two settings and to investigate current practice trends in Canada. METHODS: A detailed analysis of the costs involved both directly and indirectly in the CRIF of a hand fracture was conducted, including material and labour costs. Hospital statistical records were used to calculate efficiency. A survey was distributed to practicing plastic surgeons across Canada regarding their current practice of managing hand fractures. RESULTS: In an eight-hour surgical block we are able to perform approximately five CRIF in the OR versus eight in an ambulatory setting. The costs of performing a CRIF in the ambulatory setting under local anaesthetic, not including surgeon compensation, is $115.59 Canadian (CAD) compared to $461.27 CAD in the OR, a 299% decrease in cost. The use of a regional block increases the cost to $665.49 CAD, a 476% increase. This was due to a significant increase in labour costs, 1062% and material costs, 72%. The main barrier to performing CRIFs in an outpatient setting is the absence of equipment necessary to perform these cases effectively, based on survey results. CONCLUSION: The use of the OR for CRIF of hand fractures is associated with a significant increase in cost and hospital resources with decreased efficiency. We conclude that for appropriately selected hand fractures, CRIF in an ambulatory setting is less costly and more efficient compared to the OR and resources should be allocated to facilitate CRIF in this setting. DISCLOSURE:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in the manuscript.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".