| Abstrakt: |
Objectives: The purpose of this study was to confirm the relative safety of TKA in hospital outpatient versus inpatient settings and to assess a proposed economic model for provider and payer stakeholders. Study Design: This study employed a quasi-experimental design with a prospective treatment arm and a retrospective control arm derived from a single surgeon at a single site. Fifty subjects were prospectively enrolled to form the outpatient treatment group, and 50 subjects were drawn from previously completed inpatient cases, using matched selection criteria, to constitute the retrospective control group. Methods: The relative safety of performing TKA on the outpatient versus inpatient groups was assessed by readmission rates, clinical complications, and discharge disposition. From an economic modeling standpoint, impact on hospital revenue and payer expenditures was measured by negotiated reimbursement. Comparative resource utilization of the study hospital was measured in terms of direct costs, indirect costs, and contribution margin. Results: Readmissions and surgical complications for TKA cases were not appreciably different between study groups. Significant differences in mean measurements for the hospital outpatient versus inpatient groups were observed for all economic model parameters with the exception of indirect costs. [ABSTRACT FROM AUTHOR] |
