OBJECTIVES: Our aim was to determine the annual health insurance treatment cost of injuries to the shoulder and upper arm in Hungary.

METHODS: Data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), for the year 2018. Data analysed included annual health insurance costs, patient numbers and cost distribution calculated for age groups and sex. The following cost categories were included into the study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Patients with injuries to the shoulder and upper arm were identified with the following code of the International Classification of Diseases 10^th revision: S40-49.

RESULTS: In 2018, the Hungarian NHIFA spent 4.032 billion Hungarian Forints (HUF) on the treatment of patients with injuries to the shoulder and upper arm [14.9 million American Dollars (USD), or 12.6 million Euros (EUR)]. 46.2% of costs was spent on the treatment of male, while 53.8% on female patients. The highest patient numbers were in outpatient care: 42,588 men (50.5%), and 41,773 women (49.5%), in total 84,361 patients. Acute inpatient care (60.4% of total health insurance costs in men, 56.8% in women), outpatient care (31.5% in men, 31.5% in women) and home care (0.8% in men, 3.0% in women) were the main cost drivers, while all other forms of medical care amounted to 5.9% in men and 8.6% in women. Annual health care treatment cost per patient was 43,697HUF (162 USD/137 EUR) in men and 51,974 HUF (192 USD/163 EUR) in women.

CONCLUSIONS: Acute inpatient care was the major cost driver in the treatment of injuries to the shoulder and upper arm. Major cost drivers showed no significant difference between men and women. Average, annual health insurance costs per patient was 19% higher in women.