Cost Analysis of Trigger Finger Treatment

Purpose: the aim of this study was to perform a cost-effectiveness analysis of the most effective treatment of trigger utilizing hospital data, including actual hospital charges.

Methods: A total of 1750 encounters belonging to 1220 individual patients treated for trigger finger (ICD-9: 727.03) over a period of 3 years were studied. Utilizing CPT codes for the injection of the tendon sheath (20550) and tendon sheath incision (26055) it was determined whether a patient was treated with injection or surgery. Diabetes was determined from previous diagnosis of diabetes by ICD-9, a total of 20% of the sample (n=248). The probability of success of each treatment and the average cost of each treatment were enterered into a Markov model utilizing R software.

Results:

The overall success of the first steroid injection for trigger finger treatment was 63%, the second injection was 67%. Surgery was 100% effective. The average cost of a steroid injection was $506 and the average cost of trigger finger surgery was $5307. The recurrence rates were similar in patients with diabetes, success of treatment of first steroid injection was 63%, the second was 64% and the cost of surgery was $5380.

Conclusions:

Markov model demonstrates that the most cost-effective course of treatment for this data set is two steroid injections followed by surgery. Further analysis of the factors affecting surgical success and costs along with their effects on the Markov model analysis will be presented.