Ruiz-Betanzos ÁJ, Iglesias-Morales M, Villarreal-Ríos E, Butrón-Gandarillas MP, Galicia-Rodríguez L, Sánchez-Bermúdez MR

Language: Spanish
References: 19
Page: 134-142
PDF size: 928.07 Kb.

ABSTRACT

The objective of this study was to determine the disability cost based on the waiting time to see a physician in workers with traumatic hand injuries. A cohort study of 107 workers with hand injuries was conducted. Severity was stratified using the Mangled Upper Extremity Score (MUES). Disability cost was evaluated using the nominal salary of the Mexican Social Security Institute ($623.1 MXN/day). The effect of the waiting time to get medical care (arrival-to-incision) on days of medical leave of absence was estimated within each MUES group using an adjusted model. For population scenarios, average cost was multiplied by the number of patients and a severity weighting factor. Descriptive statistics and multiple linear regression were used. With a MUES score of 6 and an average time of 312.75 minutes, the disability cost per patient was $71,719 MXN. If attention was given within 30 minutes, the cost decreased to $49,930 MXN. Extrapolated to 6,500 patients, the total cost would be $223'502,765 MXN at 30 minutes versus $365'411,661 MXN at the average time. Reducing waiting time translates into fewer disability days and lower costs per case and at the population level. Advancing toward a "Hand Code" system focused on time targets, fast-track pathways and control dashboards is proposed to optimize functional outcomes and reduce disability costs.

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