The Narrative Review of Published Evidence on Cost Analysis and Sustainability of the Virtual Fracture Clinic Model: A Report Based Study | Chapter 5 | New Frontiers in Medicine and Medical Research Vol. 10

 Background: The Virtual Fracture Clinic (VFC) paradigm has a scarcity of published evidence at the moment. When adopting the VFC model, there are few resources from which to make conclusions about the management of orthopaedic diseases, cost effectiveness, quality and safety, patient satisfaction ratings, and management.

The goal of this narrative analysis of current published evidence is to determine how cost-effective the VFC model is for orthopaedic management of both children and adults in the United Kingdom (UK). The review also aims to identify gaps in the current body of knowledge and make recommendations for future VFC research.

Methods: Using a methodical methodology, this narrative review is secondary research of the evidence available on the VFC. Relevant peer-reviewed papers published since January 2010 were found by searching seven electronic databases. Using key word searches, the literature study discovered 678 preliminary papers (see appendix II). The method of filtering and applying the inclusion and exclusion criteria to the search retrieval was illustrated using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram, which resulted in 32 publications [1]. Following deduplication, a total of 14 relevant papers were chosen. Seven studies of diverse research types were chosen and subjected to a rigorous critical analysis [2]. Table 2 identifies the primary themes that have been chosen.

Results: There were no Randomized Controlled Trials (RCTs) or systematic reviews on VFCs that could be discovered. Following an extensive database search, seven articles were located and reviewed, including clinical audits, simulation studies, comparison studies, viewpoint analyses, and retrospective research. All of the studies were conducted in the United Kingdom. Two papers focused on Webber B ankle breaks and fifth metatarsal fractures, including Jones fractures, and one on paediatric fractures. The cost comparison and service redesign investigations were the focus of the other four research articles. All of the investigations, with the exception of one by White et al. [3], produced positive results. The cost effectiveness of VFCs ranged from £13.91 to £122 per patient. Variable cost savings ranging from £81,920 to £212,705 were also estimated by individual study trusts. Estimated values of £1,1 million per year were confirmed at a national level.

Conclusion: This narrative evaluation demonstrates that employing the VFC model can result in cost reductions. At this point, current financial expectations cannot be taken for granted. Before final judgments about the cost efficiency of the VFC model in the UK can be reached, more rigorous research such as RCTs or systematic reviews with meta-analysis is needed.

Author (S) Details

Gitana Diana Stukaite
University of Liverpool, UK.

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