Fugarino Bryce, Fox Mary Patricia, Terhoeve Cristina, Pappas Nicholas
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
J Hand Surg Am. 2017 Nov;42(11):930.e1-930.e4. doi: 10.1016/j.jhsa.2017.07.016. Epub 2017 Sep 9.
Volar plating of distal radius fractures is an increasingly common procedure. Presterilized, single-use volar plate fixation sets have been purported to increase operating room efficiency and decrease cost. The purpose of this study was to compare the actual cost of using a conventional set compared with the projected cost of using its single-use counterpart.
We retrospectively analyzed 30 consecutive cases of volar plate fixation in which conventional instrument sets were used. Hardware and processing costs were calculated for the conventional sets and compared with the projected cost of using single-use sets.
The mean total cost of hardware and processing for the conventional sets was $2,728, whereas the projected cost for the single-use sets was slightly higher at $2,868. Twenty-three of the 30 cases would have required additional screws not available in the single-use set. The cost of the additional screws needed to supplement the single-use set would have added an average of $282/case. Overall, the combined hardware and processing cost was lower for conventional sets in 25 of the 30 cases.
Although the price of the single-use set is less than the mean charge for use of a conventional set, additional screws not available in the single-use set were required in 77% of cases and consequently rendered the conventional set cheaper in 83% of cases. Stocking the single-use sets with additional screws to reflect the most commonly used screw lengths could make these sets more cost effective in the future.
TYPE OF STUDY/LEVEL OF EVIDENCE: Economic and decision analysis IV.
桡骨远端骨折掌侧钢板固定术是一种越来越常见的手术。预消毒的一次性掌侧钢板固定套件据称可提高手术室效率并降低成本。本研究的目的是比较使用传统套件的实际成本与使用一次性套件的预计成本。
我们回顾性分析了连续30例使用传统器械套件进行掌侧钢板固定的病例。计算传统套件的硬件和处理成本，并与使用一次性套件的预计成本进行比较。
传统套件的硬件和处理平均总成本为2728美元，而一次性套件的预计成本略高，为2868美元。30例病例中有23例需要使用一次性套件中没有的额外螺钉。补充一次性套件所需的额外螺钉成本平均每例增加282美元。总体而言，30例病例中有25例传统套件的硬件和处理综合成本更低。
尽管一次性套件的价格低于使用传统套件的平均费用，但77%的病例需要使用一次性套件中没有的额外螺钉，因此83%的病例中传统套件更便宜。为一次性套件储备额外的螺钉以反映最常用的螺钉长度，可能会使这些套件在未来更具成本效益。
研究类型/证据水平：经济与决策分析IV。
