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门诊关节镜下肩袖修复术的直接成本分析

Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

作者信息

Narvy Steven J, Ahluwalia Avtar, Vangsness C Thomas

机构信息

Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.

出版信息

Am J Orthop (Belle Mead NJ). 2016 Jan;45(1):E7-E11.

Abstract

Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears.

摘要

关节镜下肩袖修补术是最常开展的骨科手术之一。我们开展了一项研究,以计算经磁共振成像确诊的肩袖撕裂关节镜修复术的直接成本。在一家大型学术医疗中心的门诊手术中心,一名接受过专项培训的关节镜外科医生对26例患者(平均年龄54.5岁)的28个肩部进行了初次肩袖修补术。所有患者在术前等候区均接受了肌间沟阻滞。使用时间驱动作业成本法算法计算了这一护理周期的直接成本。平均手术时间为148分钟;平均恢复时间为105分钟。该流程周期的计算手术成本为5904.21美元。在材料成本中,缝合锚钉成本是主要成本驱动因素。23例患者进行了术前血液检查,平均增加成本111.04美元。我们的研究结果提供了有关肩袖手术直接经济成本的重要初步信息,可能有助于医院和手术中心就修复复杂撕裂伤增加的成本进行手术费用报销谈判。

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