A Comparison of the Costs of Managing Proximal Humerus Fractures in a Cohort of Patients Injured in Road Traffic Incidents Under the Transport Accident Commission Scheme in the State of Victoria

BACKGROUND: Proximal humerus fractures are becoming more prevalent with associated increases in operative management. This study aimed to compare costs between operative and non-operative management of these fractures in an Australian population. METHODS: A cost-analysis was performed in a cohort of patients initially managed at a Level 1 Trauma Centre between January 2010 and December 2018, who sustained a proximal humerus fracture following a road traffic injury. Patients were identified using ICD-10-AM coding and matched to the Victorian Orthopaedic Trauma Outcome Registry. This cohort was linked with data from the state's no-fault third-party insurer for transport injuries to obtain total claims cost data for the acute admission, subsequent admissions, and rehabilitation costs in Australian dollars. RESULTS: A total of 113 patients met the inclusion criteria; 31 non-operative and 81 operative. The mean (SD) age was 50.1 (20.3) years in the non-operative group and 44.0 (15.8) in the operative group (p = 0.10). In the non-operative group, 87% of patients sustained other injuries compared with 76% of patients in the operative group (p = 0.30). The median total treatment cost in the non-operative group was A$48 982 compared to A$36 457 in the operative group (p = 0.99). Median subsequent admission costs for the respective groups were A$9 643 and A$8 378 (p = 0.77) and median rehabilitation costs were A$6 016 and A$4 754 respectively (p = 0.95). CONCLUSION: Healthcare associated costs did not differ significantly in trauma patients with proximal humerus fractures regardless of management undertaken. Concerns regarding healthcare costs should not impact on surgical decision-making when managing these fractures.