在全膝关节置换翻修治疗过程中降低植入物成本的策略。
Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.
作者信息
Elbuluk Ameer M, Old Andrew B, Bosco Joseph A, Schwarzkopf Ran, Iorio Richard
机构信息
Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY, USA.
出版信息
Arthroplast Today. 2017 Apr 15;3(4):286-288. doi: 10.1016/j.artd.2017.03.004. eCollection 2017 Dec.
BACKGROUND
Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models.
METHODS
Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures.
RESULTS
On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone.
CONCLUSIONS
Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.
背景
植入物价格已被确定为与全膝关节置换翻修术（rTKA）相关的高成本的一个重要促成因素。本研究的目的是分析rTKA中使用的植入物成本，并将该定价与两种替代定价模型进行比较。
方法
利用我们机构的数据库，我们确定了2014年1月1日至2014年12月31日期间的52例患者。计算每个病例的组件平均成本，并与该次住院的总医院成本进行比较。然后将全组件翻修的成本与提议的“直接到医院”（DTH）标准化定价模型和固定价格翻修选项进行比较。从这些数字中计算出潜在的节省金额。
结果
平均而言，rTKA植入物花费了总医院成本的28%。所有组件翻修的平均成本为13,640美元，范围从3000美元到28,000美元。平均而言，这占总医院成本的32.7%。直接到医院的植入物定价可能为每个rTKA节省约7000美元，固定定价模型可为每个rTKA再减少1000美元——仅植入物方面每个病例可能节省8000美元。
结论
替代植入物定价模型有助于降低rTKA的总成本，这将使医院能够实现显著的成本控制。
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