Valuing the Recovery Priorities of Orthopaedic Trauma Patients After Injury: Evidence From a Discrete Choice Experiment Within 6 Weeks of Injury.

ABSTRACT

OBJECTIVES: To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities. DESIGN: Discrete choice experiment. SETTING: Academic trauma center. PATIENTS One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non-English-speaking patients were excluded. MAIN OUTCOME MEASUREMENT The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury. RESULTS: In the subacute period, clinical recovery was the main priority for fracture patients (mean 62%, SD 5.3). Work-related recovery (mean 27%, SD 3.9) and the receipt of other disability benefits (mean 11%, SD 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture. CONCLUSION: Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care. LEVEL OF EVIDENCE Level V. See Instructions for Authors for a complete description of levels of evidence.