Pang Eric Quan, Zhang Steven, Harris Alex H S, Kamal Robin N
Department of Orthopaedic Surgery, Stanford University, Stanford, CA.
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA.
J Hand Surg Am. 2017 Sep;42(9):750.e1-750.e4. doi: 10.1016/j.jhsa.2017.05.012. Epub 2017 Jun 10.
Cost minimization analysis can be employed to determine the least costly option when multiple treatments lead to equivalent outcomes. We present a cost minimization analysis from the payers' perspective, of the direct per patient cost of arthroscopic versus open ganglion cyst excision. We tested the null hypothesis that there is no difference in cost between the 2 procedures from the payer perspective.
We utilized data from a private payer administrative claims database comprising 16 million individuals from 2007 to 2015. Using Current Procedural Terminology codes to identify open and arthroscopic ganglion excisions, we extracted demographic data and fees paid to providers and facilities for the procedure.
We identified 5,119 patients undergoing open ganglion cyst excision and 20 patients undergoing arthroscopic ganglion excision. The average cost of an open excision was significantly lower than an arthroscopic excision ($1,821 vs $3,668).
Surgical costs from arthroscopic ganglion excision are significantly more than open excision. This data can inform health systems participating in value-based models.
TYPE OF STUDY/LEVEL OF EVIDENCE: Economic and Decision Analysis IV.
当多种治疗方法产生等效结果时,成本最小化分析可用于确定成本最低的选择。我们从支付方的角度,对关节镜下与开放性腱鞘囊肿切除术的每位患者直接成本进行了成本最小化分析。我们检验了零假设,即从支付方角度来看,这两种手术的成本没有差异。
我们利用了一个私人支付方管理索赔数据库中的数据,该数据库包含2007年至2015年的1600万人。使用当前程序术语代码来识别开放性和关节镜下腱鞘囊肿切除术,我们提取了人口统计学数据以及支付给医疗机构和设施的该手术费用。
我们确定了5119例行开放性腱鞘囊肿切除术的患者和20例行关节镜下腱鞘囊肿切除术的患者。开放性切除术的平均成本显著低于关节镜下切除术(1821美元对3668美元)。
关节镜下腱鞘囊肿切除术的手术成本显著高于开放性切除术。该数据可为参与基于价值模型的卫生系统提供参考。
研究类型/证据水平:经济与决策分析IV级。