Harrison Scott, Ro Jimmy, Lawendy Abdel-Rahman, Getgood Alan, Giffin Robert, Litchfield Robert, Willits Kevin, Degen Ryan M
From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Harrison); the Division of Orthopaedic Surgery, Department of Surgery, Western University, London, Ont. (Ro, Lawendy); the Fowler Kennedy Sport Medicine Clinic, Western University, London, Ont. (Getgood, Degen, Giffin, Willits, Litchfield); the Bone and Joint Institute, Western University, London, Ont. (Getgood, Degen); the Department of Surgery, Western University, London, Ont. (Getgood, Giffin, Litchfield, Willits, Degen).
From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Harrison); the Division of Orthopaedic Surgery, Department of Surgery, Western University, London, Ont. (Ro, Lawendy); the Fowler Kennedy Sport Medicine Clinic, Western University, London, Ont. (Getgood, Degen, Giffin, Willits, Litchfield); the Bone and Joint Institute, Western University, London, Ont. (Getgood, Degen); the Department of Surgery, Western University, London, Ont. (Getgood, Giffin, Litchfield, Willits, Degen)
Can J Surg. 2025 Mar 5;68(2):E89-E96. doi: 10.1503/cjs.010424. Print 2025 Mar-Apr.
Ambulatory surgery centres are becoming an attractive alternative to hospital-based outpatient departments; however, limited data exist on their cost efficacy in a publicly funded health care model. In this study, we aimed to compare costs for ambulatory sports medicine procedures performed at an ambulatory surgery centre and a hospital outpatient department.
We retrospectively identified patients who underwent rotator cuff repair, anterior cruciate ligament reconstruction (ACLR), or hip arthroscopy between January 2020 and August 2022. We collected demographic characteristics, procedural costs, and procedural data. We used 2-sample tests to compare care-related costs between groups treated in an ambulatory surgery centre and hospital outpatient department.
After controlling for age and concomitant procedures, we included a total of 132 patients for analysis. Patients who underwent hip arthroscopy or rotator cuff repair in an ambulatory surgery centre had significantly shorter duration of total operating room time, and procedural duration was equivocal ( > 0.1) between sites. Procedure time for ACLR was significantly shorter in the group treated in an ambulatory surgery centre than in the group treated in a hospital outpatient department ( = 0.01). The total case costs for the ambulatory surgery centre were significantly lower for hip arthroscopy ($3543, standard deviation (SD) $365 v. $6209, SD $681; < 0.05), rotator cuff repair ($4259, SD $934 v. $5786, SD $934; < 0.05), and ACLR ($3136, SD $459 v. $4821, SD $1511; < 0.05), despite a lack of differences in associated disposable implant costs for ACLR and rotator cuff repair ( > 0.1). Material costs were significantly lower in the group receiving hip arthroscopy at an ambulatory surgery centre than in the group receiving the same procedure at a hospital outpatient department ( < 0.05). There were no differences in immediate 6-week postoperative care-associated costs between groups ( > 0.4).
Ambulatory sports medicine procedures performed at an ambulatory surgery centre were associated with significantly reduced operating room time and total cost compared with matched cases performed via a hospital outpatient department. Ambulatory surgery centres provide an opportunity to improve cost efficacy and reduce wait-lists for surgical care.
门诊手术中心正成为医院门诊部门颇具吸引力的替代选择；然而，在公共资助的医疗保健模式下，关于其成本效益的数据有限。在本研究中，我们旨在比较在门诊手术中心和医院门诊部门进行的门诊运动医学手术的成本。
我们回顾性地确定了2020年1月至2022年8月期间接受肩袖修复、前交叉韧带重建（ACLR）或髋关节镜检查的患者。我们收集了人口统计学特征、手术成本和手术数据。我们使用双样本检验来比较在门诊手术中心和医院门诊部门接受治疗的两组患者的护理相关成本。
在控制年龄和伴随手术因素后，我们共纳入132例患者进行分析。在门诊手术中心接受髋关节镜检查或肩袖修复的患者，其总手术室时间显著缩短，且各手术部位的手术持续时间无显著差异（P>0.1）。ACLR手术组在门诊手术中心接受治疗的患者的手术时间显著短于在医院门诊部门接受治疗的患者（P=0.01）。门诊手术中心进行髋关节镜检查（3543美元，标准差（SD）365美元对6209美元，SD 681美元；P<0.05）、肩袖修复（4259美元，SD 934美元对5786美元，SD 934美元；P<0.05）和ACLR（3136美元，SD 459美元对4821美元，SD 1511美元；P<0.05）的总病例成本显著更低，尽管ACLR和肩袖修复的相关一次性植入物成本无差异（P>0.1）。门诊手术中心接受髋关节镜检查的患者组的材料成本显著低于在医院门诊部门接受相同手术的患者组（P<0.05）。两组术后6周即时护理相关成本无差异（P>0.4）。
与通过医院门诊部门进行的匹配病例相比，在门诊手术中心进行的门诊运动医学手术的手术室时间和总成本显著降低。门诊手术中心为提高成本效益和减少手术护理等待名单提供了机会。
