Resource utilization
COMPLICATIONS
Data on resource utilization were collected through questionnaires at 3, 6 and 12 months after syndesmotic fixation. The questionnaires used to evaluate in and out of hospital resource use were the iMTA Medical Consumption Questionnaire (iMCQ) and the iMTA Productivity Cost Questionnaire (iPCQ). In addition to this, patients’ medical records were screened after follow-up completion (12 months) to check for complications and revisions procedures. Resources were classified as either direct medical, direct non-medical or indirect non-medical costs. Direct medical costs were further subdivided into (1) regular in hospital costs, related to the index admission (syndesmotic screw removal, visits to outpatient clinic), (2) additional in hospital costs, related to complications or readmissions (additional implant removal, revision surgery, surgical debridement, readmission surgical ward, emergency room visits and ambulance rides), (3) out of hospital (para-)medical costs (general practitioner, company doctor, physiotherapist, home care). Indirect non-medical costs resulting from work absence or decreased productivity were determined using the iPCQ. To estimate loss of productivity, the friction costs method was used. Total costs per patient and per group were calculated by multiplying resources by the associated unit costs.