Abstract
Background:
Injuries inflicted by gunshot wounds (GSW) are an immense financial burden on the South African healthcare system. The cost of treating an abdominal GSW has previously been estimated at R30 000 per patient. No study has been conducted to estimate the financial burden from an orthopaedic perspective.
Objective:
To estimate the average cost of treating GSW victims requiring orthopedic interventions in a South African tertiary level hospital.
Methods:
The study surveyed over 1,500 orthopedic admissions to our institution during 2012 to indentify GSW patients. A folder review yielded data on theatre time, implant cost, duration of admission, diagnostic-imaging studies performed, blood products used, laboratory costs and medicines issued to analyze costs.
Results:
A total of 111 patients with an average age of 28 years (range 13–74) were identified. Each patient was hit by an average of 1.69 bullets (range 1–7). One hundred and forty seven fractures were sustained.
Ninety-five patients received surgical treatment for a total of 128 orthopedic procedures, 15 concurrent general/vascular surgery procedures, and a cumulative surgical time of 198 hours 42 minutes. Cumulative anaesthetic time was 277 hours 33 minutes.
Theatre costs (excluding implants) were estimated to be in excess of ten million rands. Ninety three of the patients received an implant during surgery which raised theatre costs even more.
Total costs were in excess of R130 000.00 forward admissions, R180 000.00 for imaging, R190 000.00 for blood products, R16 000.00 for laboratory investigations and R16 000.00 for discharge medication.
Conclusion:
Using varying calculations it was estimated that on average an orthopaedic GSW patient costs about R100 000.00 to treat, utilises about 2 hours of theatre time per operation and occupies a bed for an average period of 9 days.
