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Shifting trends in outpatient hand trauma care: a 16-year analysis at a major center in northern Germany.

Shifting trends in outpatient hand trauma care: a 16-year analysis at a major center in northern Germany.

Authors :
Tamulevicius M
Bucher F
Dastagir N
Obed D
Vogt PM
Dastagir K
Source :
Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2025 Jan 04; Vol. 145 (1), pp. 109. Date of Electronic Publication: 2025 Jan 04.
Publication Year :
2025

Abstract

Background: Hand injuries are a leading cause of emergency department visits. Recent trends in hand trauma management reflect a shift toward outpatient care, driven by factors such as a shortage of skilled personnel or increasing cost pressures. This study analyzed these trends to propose updated management strategies for hand injuries.<br />Materials and Methods: This retrospective cohort study included 14,414 patients treated at a certified major hand surgical trauma center between 2007 and 2022. Patients were divided into two groups: the earlier cohort (EC, 2007-2014) and the current cohort (CC, 2015-2022). Trends in inpatient and outpatient care, as well as hospitalization durations, were analyzed.<br />Results: During the study period, approximately one-third of all patients required inpatient treatment, with one-third of hospitalized patients staying at least one week, one-fifth staying two weeks, and one-tenth staying three or more weeks. Inpatient treatment rates decreased annually by 7%, while outpatient care increased by 5.3% annually. A significant shift toward outpatient management was noted for various injuries, including fractures, burns, lacerations, dislocations, complex injuries, and infections. Despite declining hospitalization rates, patients in the CC group had significantly longer hospital stays, reflecting the increasing complexity and severity of cases requiring admission (pā€‰<ā€‰0.001).<br />Conclusions: This study reveals a growing trend toward outpatient care for hand injuries, reflecting improved efficiency without compromising quality. Although fewer patients are hospitalized, those admitted require more intensive care, highlighting a shift toward ambulatory management for moderately severe cases. These findings emphasize the importance of initial injury management and underscore the need for expanding outpatient hand surgical care to meet growing demand in a rapidly changing healthcare landscape.<br />Level of Evidence: III.<br />Competing Interests: Declarations. Conflicting interests: All authors declare that they have no conflicting interests. Ethical approval: Ethical approval was waived by the local Ethics Committee in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. The study was performed in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent: Informed consent was not obtained as a study was done in an anonymized retrospective manner.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
1434-3916
Volume :
145
Issue :
1
Database :
MEDLINE
Journal :
Archives of orthopaedic and trauma surgery
Publication Type :
Academic Journal
Accession number :
39755809
Full Text :
https://doi.org/10.1007/s00402-024-05745-0