Medico-Economic and Medico-Social Evaluation of Two Types of Treatment for Clubfoot in France: A Prospective Study Using a Mixed Methods Approach.
7 affiliations
- 1Unité de Recherche Clinique en Économie de la Santé (URC Eco), Assistance Publique-Hôpitaux de Paris, 1 Place du Parvis Notre-Dame, F-75004 Paris, France.
- 2Inserm, ECEVE, Université Paris Cité, F-75010 Paris, France.
- 3Unité de Recherche Clinique, AP-HP, Hôpital Universitaire Robert Debré, F-75019 Paris, France.
- 4Unité REPERES, AP-HP, Hôpital Universitaire Robert Debré, F-75019 Paris, France.
- 5AP-HP, Unité D'épidémiologie Clinique, Inserm, CIC-EC 1426, Université Paris Cité, F-75010 Paris, France.
- 6INSERM 1153 Centre de Recherche en Epidémiologie et Statistiques (CRESS), Sorbonne Paris Cité, F-75004 Paris, France.
- 7Service de Chirurgie Pédiatrique Orthopédique, AP-HP, Hôpital Universitaire Robert Debré, F-75019 Paris, France.
Abstract
Background/Objectives: Congenital clubfoot is the most frequent malformation in pediatric orthopedics. In France, two treatments can be proposed: the Ponseti method and the functional method. The objective was to conduct a medico-economic and -social evaluation of those methods. Methods: Medico-economic: a cost-consequences analysis was undertaken from the societal perspective, based on the Dimeglio score at 24 months in four pediatric hospitals. Medico-social: interviews were conducted with parents (n = 16) and healthcare professionals (n = 16). Results: One hundred patients were included between January 2014 and December 2016. Whatever the treatment method, over 90% of patients presented with benign clubfoot (i.e., Dimeglio score < 5/20) at 24 months, based on multiply imputed estimates. The Functional method was associated with higher direct medical and non-medical costs (€3340-4061 vs. 889-2318; €6275-5968 vs. 576-726), and indirect costs (€15,441-4672 vs. 1416-1786), contrary to out-of-pocket expenses (€0-1 vs. €322-546). Family testimonies underscored the importance of communication from healthcare providers to reassure and guide parents. Although the choice is influenced by professionals, trust and active engagement of families are essential for adherence to treatment and its long-term success. The Ponseti method combined effectiveness with a lower perceived burden for families. Conclusions: The Ponseti method was the costliest for parents, yet more manageable. However, the most important factor is to choose a method adapted to the family in order to achieve the best degree of compliance.
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BibTeX
@article{jeannic2026medicoeconomic,
title = {{Medico-Economic and Medico-Social Evaluation of Two Types of Treatment for Clubfoot in France: A Prospective Study Using a Mixed Methods Approach.}},
author = {Anaïs Le Jeannic and Belkacem Zenati and Clément Picot-Ngo and Sophie Guilmin-Crépon and Maria Texeira and Agathe Turpin and Priscilla Boizeau and Arnaud Nze Ossima and Corinne Alberti and Isabelle Durand-Zaleski and Ana Presedo and On Behalf Of The Mespieds Investigators},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203519},
url = {https://europepmc.org/article/MED/42940564},
note = {CC BY},
}
RIS
TY - JOUR
TI - Medico-Economic and Medico-Social Evaluation of Two Types of Treatment for Clubfoot in France: A Prospective Study Using a Mixed Methods Approach.
AU - Anaïs Le Jeannic
AU - Belkacem Zenati
AU - Clément Picot-Ngo
AU - Sophie Guilmin-Crépon
AU - Maria Texeira
AU - Agathe Turpin
AU - Priscilla Boizeau
AU - Arnaud Nze Ossima
AU - Corinne Alberti
AU - Isabelle Durand-Zaleski
AU - Ana Presedo
AU - On Behalf Of The Mespieds Investigators
PY - 2026
DA - 2026/10/19
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203519
UR - https://europepmc.org/article/MED/42940564
AB - Background/Objectives: Congenital clubfoot is the most frequent malformation in pediatric orthopedics. In France, two treatments can be proposed: the Ponseti method and the functional method. The objective was to conduct a medico-economic and -social evaluation of those methods. Methods: Medico-economic: a cost-consequences analysis was undertaken from the societal perspective, based on the Dimeglio score at 24 months in four pediatric hospitals. Medico-social: interviews were conducted with parents (n = 16) and healthcare professionals (n = 16). Results: One hundred patients were included between January 2014 and December 2016. Whatever the treatment method, over 90% of patients presented with benign clubfoot (i.e., Dimeglio score < 5/20) at 24 months, based on multiply imputed estimates. The Functional method was associated with higher direct medical and non-medical costs (€3340-4061 vs. 889-2318; €6275-5968 vs. 576-726), and indirect costs (€15,441-4672 vs. 1416-1786), contrary to out-of-pocket expenses (€0-1 vs. €322-546). Family testimonies underscored the importance of communication from healthcare providers to reassure and guide parents. Although the choice is influenced by professionals, trust and active engagement of families are essential for adherence to treatment and its long-term success. The Ponseti method combined effectiveness with a lower perceived burden for families. Conclusions: The Ponseti method was the costliest for parents, yet more manageable. However, the most important factor is to choose a method adapted to the family in order to achieve the best degree of compliance.
SN - 2227-9032
ER -