儿童下肢割草机创伤性截肢术后长期使用假肢的成本

来源 :世界核心医学期刊文摘(儿科学分册) | 被引量 : 0次 | 上传用户:dudulee
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Objectives: To evaluate prosthetic costs of pediatric lawnmower amputations; t o see if reducing the incidence of pediatric lawnmower amputations could result in significant cost savings; and to consider if a cost analysis could be useful to implement more safety features (voluntarily or legislatively). Design: Pediat ric lawnmower amputees from 1980 to 2000 were reviewed to determine age at time of injury, level of amputation, number of prostheses, and lifetime per prosthesi s. A standard prosthetic program beginning at amputation and ending at age 18 ye ars was constructed. An aggregate cost was calculated according to the proportio n of amputation levels. The cost burden for prosthetic care was estimated from t he statistics of US pediatric lawnmower injuries. Setting: Referral pediatric or thopedic center. Patients: Fifty-three lower extremity amputees with 58 lower e xtremity amputations at a mean ±SD age of 4.7 ±2.5 years were reviewed. Resu lts: The percentage of amputee children injured by riding lawnmowers was 80%; t he percentage injured by riding lawnmowers engaged in reverse was 39%. Prosthet ic costs from the time of injury to the age of 18 years range from $73140 to $ 116040 per single lower extremity amputation. With 600 to 650 new childhood ampu tations per year due to lawnmowers, the new annual burden for prosthetic costs t hus ranges from $43.88 to $75.42 million, or (600) ($73140)-to (650) ($11 6040). Conclusions: Further encouragement of lawnmower manufacturers to install improved safety devices (such as those to disengage power while in reverse mode of operation), new research on improved safety measures, and continued promotion of educational campaigns regarding the dangers of children being around and/or operating riding lawnmowers and garden tractors should be pursued. This will res ult in significant cost savings aswell as incalculable health savings. Objectives: To evaluate if reducing the incidence of pediatric lawnmower amputations could result in significant cost savings; and to consider if a cost analysis could be useful to implement more safety features (voluntarily or legislatively). Design : Pediat ric lawnmower amputees from 1980 to 2000 were reviewed to determine age at time of injury, level of amputation, number of prostheses, and lifetime per prosthesi s. A standard prosthetic program beginning at amputation and ending at age 18 ye ars was constructed. An aggregate cost was calculated according to the proportio n of amputation levels. The cost burden for prosthetic care was estimated from t he statistics of US pediatric lawnmower injuries. Settings: Referral pediatric or thopedic center. Patients: Fifty-three lower extremity amputees with 58 lower e xtremity amputations at a mean ± SD age of 4.7 ± 2.5 years were reviewed. Resu lts: The percentage of amputee child ren injured by riding lawnmowers was 80%; t he percentage injured by riding lawnmowers engaged in reverse was 39%. Prosthet ic costs from the time of injury to the age of 18 years range from $ 73140 to $ 116040 per single lower extremity amputation. With 600 to 650 new childhood ampu tations per year due to lawnmowers, the new annual burden for prosthetic costs t hus ranges from $ 43.88 to $ 75.42 million, or (600) ($ 73140) -to (650) ($ 11 6040) Conclusions: Further encouragement of lawnmower manufacturers to install improved safety devices (such as those to disengage power while in reverse mode of operation), new research on improved safety measures, and continued promotion of educational campaigns regarding the dangers of children being around and / or operating riding lawnmowers and garden tractors should be pursued. This will res ult in significant cost savings aswell as incalculable health savings.
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