Inpatient cost comparison of total and unicompartmental knee arthroplasty in patients with medial compartmental osteoarthritis using time-driven activity-based costing

被引:0
|
作者
Lim, Perry L. [1 ,2 ]
Gonzalez, Marcos R. [1 ,2 ]
Goh, Graham S. [3 ]
Melnic, Christopher M. [1 ,2 ]
Bedair, Hany S. [1 ,2 ]
机构
[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthopaed Surg, 55 Fruit St, Boston, MA 02114 USA
[2] Newton Wellesley Hosp, Dept Orthopaed Surg, Newton, MA USA
[3] Boston Univ, Med Ctr, Dept Orthopaed Surg, Boston, MA USA
关键词
cost; cost analysis; isolated medial compartmental osteoarthritis; time-driven activity-based costing; total knee arthroplasty; unicompartmental knee arthroplasty; HIGHER REVISION RATES; UNICONDYLAR; COMPLICATIONS; REPLACEMENT; RISK;
D O I
10.1002/ksa.12543
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposeUsing time-driven activity-based costing (TDABC), we sought to compare the total facility costs, comprising supply and personnel costs during the episode of care for the index procedure, in patients with isolated medial compartmental knee osteoarthritis (OA) undergoing unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA). MethodsWe conducted a retrospective analysis of 100 UKAs and 100 TKAs from 2019 to 2022. From a larger sample of 4899 TKAs and 137 UKAs, patients with isolated medial OA (Kellgren-Lawrence Grade <2 in other compartments) were radiographically identified. Demographic data included age, sex and body mass index, with comorbidities controlled using the Charlson comorbidity index. Facility costs were calculated using TDABC and standardized in cost units (CUs), a metric for comparing costs across procedures. Multiple regression analysis was used to assess the independent effect of TKA versus UKA on facility costs. ResultsTKA patients had similar operative times (TKA vs. UKA: 1.01x, p = 0.783) and supply costs (1.00x, p = 0.866), where 'x' denotes the relative cost ratio. However, TKA was associated with higher personnel costs (260.0 vs. 222.5 CUs [1.17x], p < 0.001) and total facility costs, both including (706.3 vs. 667.5 CUs [1.06x], p = 0.007) and excluding implants (353.8 vs. 312.5 CUs [1.13x], p < 0.001). Adjusted for demographics and comorbidities, TKA had increased facility costs, including (32.2 CUs, 95% confidence interval [CI]: 2.9-61.5, p = 0.031) and excluding implants (37.8 CUs, 95% CI: 15.2-60.3, p = 0.001). ConclusionsTDABC analysis revealed higher total facility costs for the index procedure in TKA, suggesting UKA may be a cost-saving alternative for isolated medial compartment knee OA. Level of EvidenceLevel III, retrospective comparative study.
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页数:9
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