The aims of this study were to estimate the cost of surgical
treatment of fractures of the proximal humerus using a micro-costing
methodology, contrast this cost with the national reimbursement
tariff and establish the major determinants of cost. A detailed inpatient treatment pathway was constructed using
semi-structured interviews with 32 members of hospital staff. Its
content validity was established through a Delphi panel evaluation.
Costs were calculated using time-driven activity-based costing (TDABC)
and sensitivity analysis was performed to evaluate the determinants
of costAims
Methods
Tears of the rotator cuff are a common pathology and poorly understood. Achieving a good functional outcome for patients may be difficult, and the degree of fat infiltration into the muscle is known to be a major determining factor to surgical repair and post operative function. It is the hypothesis of this study that the degree of retraction of the common central tendon as seen on MRI corresponds to the amount of fat infiltration classified according to the Goutallier grading System. MRI scans of the supraspinatus were reviewed and two groups identified: no tear (NT) and full thickness tear (FTT). The following measures were taken: central tendon retraction (CTR) and the Goutallier Grade according to MRI. The difference between Goutallier grade between NT and FTT were measured using the Mann-Whitney test. The relationship between Goutallier grade and increasing amount of CTR was described using Spearman's rank correlation and differences assessed using Mann-Whitney tests.Background
Methods