The primary cost drivers of arthroscopic rotator cuff repair surgery: a cost-minimization analysis of 40,618 cases
| Autor: | Steven L. Bokshan, Brett D. Owens, Lauren V. Ready, Lambert T. Li |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Shoulder surgery medicine.medical_treatment Operative Time Comorbidity Medicare Rotator Cuff Injuries Arthroscopy 03 medical and health sciences Sex Factors 0302 clinical medicine Anesthesia Conduction Suture Anchors medicine Humans Orthopedics and Sports Medicine Rotator cuff health care economics and organizations Average cost 030222 orthopedics Univariate analysis medicine.diagnostic_test Shoulder Joint business.industry Age Factors Health Care Costs 030229 sport sciences General Medicine Decompression Surgical United States Surgery Black or African American medicine.anatomical_structure Cost driver Cost-minimization analysis Costs and Cost Analysis Income Current Procedural Terminology Female business |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 28:1977-1982 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2019.03.004 |
| Popis: | An estimated 250,000 rotator cuff repair (RCR) surgical procedures are performed every year in the United States. Although arthroscopic RCR has been shown to be a cost-effective operation, little is known about what specific factors affect the overall cost of surgery. This study examines the primary cost drivers of RCR surgery in the United States.Univariate analysis was performed to determine the patient- and surgeon-specific variables for a multiple linear regression model investigating the cost of RCR surgery. The 2014 State Ambulatory Surgery and Services Databases were used, yielding 40,618 cases with Current Procedural Terminology code 29827 ("arthroscopic shoulder rotator cuff repair").The average cost of RCR surgery was $25,353. Patient-specific cost drivers that were significant under multiple linear regression included black race (P.001), presence of at least 1 comorbidity (P.001), income quartile (P.001), male sex (P = .012), and Medicare insurance (P = .035). Surgical factors included operative time (P.001), use of regional anesthesia (P.001), quarter of the year (January to March, April to June, July to September, and October to December) (P.001), concomitant subacromial decompression or distal clavicle excision (P.001), and number of suture anchors used (P.001). The largest cost driver was subacromial decompression, adding $4992 when performed alongside the RCR.There are several patient-specific variables that can affect the cost of RCR surgery. There are also surgeon-controllable factors that significantly increase cost, most notably subacromial decompression, distal clavicle excision, use of regional anesthesia, and number of suture anchors. Surgeons must consider these factors in an effort to minimize cost, particularly as bundled payments become more common. |
| Databáze: | OpenAIRE |
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