Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Bone Joint J. 2020 Jun;102-B(6_Supple_A):79-84. doi: 10.1302/0301-620X.102B6.BJJ-2019-1498.R1.
The aim of this study was to analyze the true costs associated with preoperative CT scans performed for robotic-assisted total knee arthroplasty (RATKA) planning and to determine the value of a formal radiologist's report of these studies.
We reviewed 194 CT reports of 176 sequential patients who underwent primary RATKA by a single surgeon at a suburban teaching hospital. CT radiology reports were reviewed for the presence of incidental findings that might change the management of the patient. Payments for the scans, including the technical and professional components, for 330 patients at two hospitals were also recorded and compared.
There were 82 incidental findings in 61 CT studies, one of which led to a recommendation for additional testing. Across both institutions, the mean total payment for a preoperative scan was $446 ($8 to $3,870). The mean patient payment was $71 ($0 to $2,690). There was wide variation in payments between the institutions. In Institution A, the mean total payment was $258 ($168 to $264), with a mean patient payment of $57 ($0 to $100). The mean technical payment in this institution was $211 ($8 to $856), while the mean professional payment was $48 ($0 to $66). In Institution B, the mean total payment was $636 ($37 to $3,870), with a mean patient payment of $85 ($0 to $2,690).
The total cost of a CT scan is low and a minimal part of the overall cost of the RATKA. No incidental findings identified on imaging led to a change in management, suggesting that the professional component could be eliminated to reduce costs. Further studies need to take into account the patient perspective and the wide variation in total costs and patient payments across institutions and insurances. Cite this article: 2020;102-B(6 Supple A):79-84.
本研究旨在分析机器人辅助全膝关节置换术（RATKA）术前 CT 扫描相关的真实成本，并确定正式放射科医生对此类研究报告的价值。
我们回顾了在一所郊区教学医院由一位外科医生对 176 例连续患者进行的 194 例 RATKA 患者的 CT 报告。对 CT 影像学报告进行了回顾，以确定是否存在可能改变患者治疗方案的偶然发现。还记录并比较了这两家医院 330 例患者的扫描费用，包括技术和专业部分。
在 61 例 CT 研究中，有 82 例偶然发现，其中一例建议进行额外检查。在两家医院中，术前扫描的平均总费用为 446 美元（8 美元至 3870 美元）。患者的平均支付额为 71 美元（0 美元至 2690 美元）。两家医院之间的支付差异很大。在 A 医院，平均总支付额为 258 美元（168 美元至 264 美元），患者平均支付额为 57 美元（0 美元至 100 美元）。该机构的平均技术支付额为 211 美元（8 美元至 856 美元），而平均专业支付额为 48 美元（0 美元至 66 美元）。在 B 医院，平均总支付额为 636 美元（37 美元至 3870 美元），患者平均支付额为 85 美元（0 美元至 2690 美元）。
CT 扫描的总成本较低，仅占 RATKA 总费用的一小部分。影像学检查未发现偶然发现导致治疗方案改变，这表明可以消除专业部分以降低成本。进一步的研究需要考虑患者的观点以及机构和保险之间总成本和患者支付额的广泛差异。
