Rosas Samuel, Kurowicki Jennifer, Hughes Michael, Sabeh Karim, Sheu Jonathan, Baraga Michael
Department of Orthopaedic Surgery, Forest School of Medicine Winston-Salem, North Carolina.
Department of Orthopaedic Surgery, School of Health and Medical Sciences, Seton Hall University, South Orange, New Jersey.
Surg Technol Int. 2017 Dec 22;31:285-293.
Anterior cruciate ligament tears are an unfortunate, but common, event in the United States, with an estimated 100-300,000 reconstructions performed annually. Limited literature has been published analyzing the reimbursement patterns for the reconstruction of this ligament and, thus, cost-effectiveness studies have relied mainly on data from a limited number of subjects and hospitals.
The purpose of this study was to perform an epidemiological cost analysis of anterior cruciate ligament reconstructions and to analyze and describe the reimbursement patterns for this procedure that can be used as reference for future cost-analysis studies. We conducted a retrospective review of a large private payers insurance company records to identify patients who underwent ACL reconstruction (ACLR) between 2007 and 2014.
This was achieved through a structured query of the database with the use of current procedural terminology (CPT) codes. Inclusion criteria for this study were patients housed in the insurer database between the ages of 10 and 59. Reimbursements were calculated at the day of surgery and the 90-day global period. Statistical analysis was based on growth and cohort comparison according to demographic. The consumer price index (CPI) of the Bureau of Labor Statistics was used to calculate inflation.
The adjusted mean same-day costs were $11,462 (standard deviations [SD] of $869) for female patients and $12,071 (SD of 561) for males (p=0.07), with no significant difference among same-day costs in either females (p=0.023 for ages 10 to 34 and p=0.037 for ages 35 to 59) or males (p=0.46 for ages 10 to 34 and p=0.26 for ages 35 to 59). The adjusted mean 90-day costs were $14,569 (SD of $835) for females and $14,916 (SD of $780) for males, with no significant difference among 90-day costs in either females (p=0.229 for ages 10 to 34 and p= 0.386 for ages 35 to 39) or males (p=0.425 for ages 10 to 34 and p=0.637 for ages 35 to 39). A matched-age cost analysis demonstrated that gender did not play a significant role in costs (p<0.01 for all groups).
In the setting of arthroscopic ACLR, both same-day and 90-day costs do not significantly differ between age-matched males and females.
在美国，前交叉韧带撕裂虽不幸但很常见，据估计每年进行100,000至300,000例重建手术。分析该韧带重建报销模式的文献有限，因此，成本效益研究主要依赖于来自有限数量的受试者和医院的数据。
本研究的目的是对前交叉韧带重建进行流行病学成本分析，并分析和描述该手术的报销模式，可为未来的成本分析研究提供参考。我们对一家大型私人医疗保险理赔公司的记录进行了回顾性研究，以确定2007年至2014年间接受前交叉韧带重建（ACLR）的患者。
这是通过使用当前手术术语（CPT）代码对数据库进行结构化查询来实现的。本研究的纳入标准是年龄在10至59岁之间且纳入保险公司数据库的患者。报销金额在手术当天和90天的整体期间进行计算。统计分析基于根据人口统计数据的增长和队列比较。劳工统计局的消费者价格指数（CPI）用于计算通货膨胀。
女性患者当日调整后平均费用为11,462美元（标准差[SD]为869美元），男性为12,071美元（SD为561美元）（p = 0.07），女性当日费用在各年龄组间无显著差异（10至34岁组p = 0.023，35至59岁组p = 0.037），男性也无显著差异（10至34岁组p = 0.46，35至59岁组p = 0.26）。女性90天调整后平均费用为14,569美元（SD为835美元），男性为14,916美元（SD为780美元），女性90天费用在各年龄组间无显著差异（10至34岁组p = 0.229，35至39岁组p = 0.386），男性也无显著差异（10至34岁组p = 0.425，35至39岁组p = 0.637）。配对年龄成本分析表明，性别在成本方面未发挥显著作用（所有组p<0.01）。
在关节镜下ACLR手术中，年龄匹配的男性和女性在当日及90天费用方面无显著差异。
