Demographic profiling and cost-analysis of orthopedic care in methamphetamine users at a Canadian level 1 trauma center

Background: Methamphetamine (meth) is an addictive stimulant that increases risk of trauma and infections. Global meth use continues to rise and the economic impact of meth use on the orthopedic trauma system is poorly understood. This study aims to identify the economic impact meth use exerts on emergent orthopedic care. Methods: The meth user cohort was identified using the Manitoba Centre for Health Policy (MCHP) database and compared to a matched control group based on age, sex, income quintile (Q) and orthopedic diagnosis (between 2015 and 2019). Healthcare spending during the first year following injury was calculated using hospital abstract data and adjusted for inflation. Results: A total of 109 meth users were identified, including 49 (45.0 %) males and 60 (55.0 %) females. Eighty-eight (81.0 %) meth users were classified as low-income (Q1-2), while 21 (19.3 %) were above low-income (Q3-5). Seventy-two (66.1 %) were in the 18–39 age range, while 37 (34.0 %) were in the 40–64 age range. Fifty-eight meth users (28 male (48.3 %), 30 female (51.7 %)) comprised orthopedic diagnoses with unsuppressed data (n > 5), including septic arthritis (18), forearm fractures (14), vertebrae fractures (7), tibia fractures (7), spine infections (6) and ankle/hindfoot fractures (6). The one-year healthcare cost-ratios for meth users were: septic arthritis 1.68 (p = 0.021), forearm fractures 3.18 (p < 0.0001), vertebrae fractures 0.56 (p = 0.12), tibia fractures 1.47 (p = 0.22), spine infections 0.72 (p = 0.40) and ankle/hindfoot fractures 1.30 (p = 0.19). The total one-year cost-ratio for meth users was 1.99 (p < 0.0001). Conclusion: There is significant resource utilization among meth users undergoing emergent orthopedic surgery. Meth users in our study demonstrated higher treatment costs, particularly for septic arthritis and forearm fractures. Healthcare providers and policymakers must prioritize strategies aimed at harm reduction to minimize adverse patient outcomes and healthcare spending.