Disparities Exist in the Experience of Financial Burden Among Orthopedic Trauma Patients: A Systematic Review.

PURPOSE OF REVIEW: There are substantial costs associated with orthopedic injury and management. These costs are likely not experienced equally among patients. At the level of the healthcare and hospital systems, disparities in financial burden and patient demographics have already been identified among orthopedic trauma patients. Accordingly, disparities may also arise at the level of the patient and how they experience the cost of their care. We sought to determine (1) how patient demographics are associated with financial burden/toxicity and (2) if patients experience disproportionate financial burden/toxicity and social support secondary to their economic standing. RECENT FINDINGS: It has been described that there is an inequitable experience in clinical and economic outcomes in certain socioeconomic demographics leading to disparities in financial burden. It has been further reported that orthopedic injury, management, and outcomes are not experienced equitably among all demographic and socioeconomic groups. Ten articles met inclusion criteria, among which financial burden was disproportionately experienced amid orthopedic trauma patients across age, gender, race, education, and marital status. Financial hardship was also unequally distributed among different levels of income, employment, insurance status, and social deprivation. Younger, female, non-White, and unmarried patients experience increased financial burden. Patients with less education, lower income, limited or no insurance, and greater social deprivation disproportionately experienced financial toxicity compared to patients of improved economic standing. Further investigation into policy changes, social support, and barriers to appropriate care should be addressed to prevent unnecessary financial burden and promote greater patient welfare.

A Rare Case of Spontaneous Intussusception in an Elderly Patient.

Intussusception is an uncommon pathology in the adult population. Most intussusception cases result from an underlying pathological lead point, oftentimes a malignant neoplasm. We report a case of intussusception in an adult male patient who presented with abdominal pain and currant jelly diarrhea. The patient underwent laparoscopic right hemicolectomy and the biopsy of the affected colon did not show any pathological lead point. Intussusception remains an important differential diagnosis in patients presenting with abdominal pain and bloody diarrhea.