engleski

Clinical and financial assessment of treatment using proximal femoral nail antirotation (PFNA) method in elderly

Introduction This paper tries to answer whether surgically repaired fracture of the femur in the elderly using Proximal Femoral Nail Antirotation (PFNA) method can be fi nancially viable in the hospital system and eff ective for patients and medical institution.Patients and Methods Th is retrospective study analysed the newly-arrived and operated patients from 1st of January 2015 to 31st of December 2015, using Proximal Femoral Nail Antirotation (PFNA) method and invoiced re-alization by the patient in the County General Hospital in Vukovar at the Department of Chirurgic and outcomes involving payment according to Diagnos-tic Related Groups (DRGs) and set prices according to the Croatian Institute for Health Insurance (CIHI).Results In this study 37 patients (M-8, F-29) has been treated using PFNA with a mean age of 79.9 years. All patients had been operated during 24 hours after admission to the hospital. Th e surgical procedure lasted between 35 to 60 minutes. Th e postoperative course has resulted with no infection, no implant breaks and no migration of the implant. Th e day after surgery, the patient gets up with the help of equipment and assistance of physiotherapists, on the 7th day the patients were released from the institution and continued the rehabilitation at the spa. Fracture healed six months later.According to DRG, the CIHI reallocates HRK 18, 525.00 for a single case of PFNA insertion, and ultimately it amounted to HRK 685, 425.00 for 2015. Th e overall average saving amounts to HRK 198, 872.47, minimum invoice (bill) is HRK 9, 721.51 with the highest amounting to HRK 18, 716.07.Th is way of thinking is called cost and decisions management! Which method to use and which decision to make? Any good or bad judgment is a decision, and a decision in health care is money.Conclusion Th is study shows that the use of PFNA for treating intertrochan-teric fracture in elderly patients is the method of choice because of simplicity of the operation, few complications, clinical treatment is brief and ultimately it has proven as a good fi nancial effi ciency of the institution

clinical assessment, PFNA, fi nancial feasibility, DRG

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