The integration of a Podiatrist into an orthopaedic department: a cost-consequences analysis

dc.contributor.author Walsh, Tom P
dc.contributor.author Ferris, Linda R
dc.contributor.author Cullen, Nancy C
dc.contributor.author Brown, Christopher
dc.contributor.author Loughry, Cathy J
dc.contributor.author McCaffrey, Nicola
dc.date.accessioned 2017-11-06T23:13:07Z
dc.date.available 2017-11-06T23:13:07Z
dc.date.issued 2017-10-12
dc.description This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.description.abstract Background The aim of this study was to evaluate the cost-consequences of a podiatry-led triage clinic provided in an orthopaedic department relative to usual care for non-urgent foot and ankle complaints in an Australian tertiary care hospital. Methods All new, non-urgent foot and ankle patients seen in an outpatient orthopaedic department were included in this study. The patients seen between 2014 and 2015 by Orthopaedic Surgeons were considered ‘usual care’, the patients seen between 2015 and 2016 by a Podiatrist were considered the ‘Podiatry Triage Clinic’. Data on new and review patient appointments; the number of new patients / session; the number of appointments / patient; the number of patients discharged; the surgical conversion rate; staff time; and imaging use were collected. A cost-consequences analysis, undertaken from a healthcare provider perspective (hospital) estimated the incremental resource use, costs and effects of the Podiatry Triage Clinic relative to usual care over a 12-month period. Results The Orthopaedic Surgeons and Podiatrist consulted with 72 and 212 new patients during the usual care and triage periods, respectively. The Podiatrist consulted with more new patients / session, mean (SD) of 3.6 (1.0) versus 0.7 (0.8), p < 0.001 and utilised less appointments / patient than the Orthopaedic Surgeons, mean (SD) of 1.3 (0.6) versus 1.9 (1.1), p < 0.001. The percentage of patients discharged without surgery was similar in the Podiatry Triage Clinic and usual care, 80.3% and 87.5% p = 0.135, respectively, but the surgical conversion rate was higher in the Podiatry Triage Clinic, 76.1% versus 12.5% p < 0.001. The total integrated appointment cost for the 12-month usual care period was $32,744, which represented a cost of $454.78 / patient. The total appointment and imaging cost during the triage period was $19,999, representing $94.34 / patient. Further analysis, suggests that the projected annual saving of integrating a Podiatry Triage Clinic versus an orthopaedic clinic alone is $50,441. Conclusions The integration of a Podiatrist into an orthopaedic department significantly increases the number of patients seen, is cost-effective, improves the surgical conversion rate and improves the utilisation of Orthopaedic Surgeons. en
dc.identifier.citation Walsh, T. P., Ferris, L. R., Cullen, N. C., Brown, C. H., Loughry, C. J., & McCaffrey, N. M. (2017). The integration of a Podiatrist into an orthopaedic department: a cost-consequences analysis. Journal of Foot and Ankle Research, 10(1). https://doi.org/10.1186/s13047-017-0227-0 en
dc.identifier.doi https://doi.org/10.1186/s13047-017-0227-0 en
dc.identifier.issn 1757-1146
dc.identifier.uri http://hdl.handle.net/2328/37672
dc.language.iso en
dc.oaire.license.condition.license CC-BY
dc.publisher BioMed Central en
dc.rights © The Author(s). 2017 en
dc.rights.holder The Author(s). en
dc.subject Medical economics
dc.subject Clinical pathways
dc.subject Podiatry
dc.subject Orthopaedics
dc.title The integration of a Podiatrist into an orthopaedic department: a cost-consequences analysis en
dc.type Article en
local.contributor.authorOrcidLookup McCaffrey, Nicola: https://orcid.org/0000-0003-3684-3723 en_US
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