Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies.

ABSTRACT

PURPOSE: We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost. METHODS: National data on tibial plateau fractures were collected from the NIHDI and compared to our performance. Several clinical parameters, such as age, sex, treatment modality and length-of-stay, were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs. RESULTS: Between 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 at our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of non-operatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay. CONCLUSION: Since length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this. LEVEL OF EVIDENCE Level IV.