Total Knee Arthroplasty Hospital Costs by Time-Driven Activity-Based Costing: Robotic vs Conventional.
Total Knee Arthroplasty Hospital Costs by Time-Driven Activity-Based Costing: Robotic vs Conventional.
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DOI：
10.1016/j.artd.2021.11.008
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发表时间：
2022-03
影响因子：
--
通讯作者：
Smith EL
中科院分区：
文献类型：
--
作者：
Fang CJ;Mazzocco JC;Sun DC;Shaker JM;Talmo CT;Mattingly DA;Smith EL
全膝关节置换术（TKA）是一项主要的国家卫生支出。过去十年，机器人辅助TKA（roTKA）激增;然而，与传统TKA（cTKA）相比，关于roTKA成本的文献有限。本研究旨在评估与cTKA相比，roTKA的相关成本。这是一项回顾性队列成本分析研究，研究对象为2020年7月至2021年3月接受初次、择期roTKA或cTKA的患者。时间驱动的作业成本法（TDABC）被用来确定粒度成本。比较患者人口统计学资料、医疗/手术细节和费用。共分析了2058例TKA（1795例cTKA和263例roTKA）。roTKA患者更常为男性（50.2% vs 42.3%; P = .016），出院回家（98.5% vs 93.7%; P = .017），手术室（OR）时间更长（144.6 vs 130.9分钟; P < .0001），住院时间（LOS）更短（1.8 vs 2.1天; P < .0001）。不包括植入物的供应品成本为2.17倍（P < .0001），总供应品成本为1.18倍（P < .0001），手术室人员成本为1.12倍（P < .0001），总人员成本为1.05倍（P = .0001）。植入成本相似（P = 0.076），但麻醉后监护室人员（P = 0.018）和住院人员（P <0.0001）的植入成本分别为0.98倍和0.84倍。roTKA的总住院费用是cTKA的1.10倍（P < .0001）。roTKA的总住院费用高于cTKA。尽管较低的LOS，较长的OR时间与较高的供应和人员成本导致了昂贵的程序。在考虑这项现代技术的价值（即，每美元支出的结果）时，了解roTKA的成本至关重要。
Total knee arthroplasty (TKA) represents a major national health expenditure. The last decade has seen a surge in robotic-assisted TKA (roTKA); however, literature on the costs of roTKA as compared to conventional TKA (cTKA) is limited. The purpose of this study was to assess the costs associated with roTKA as compared to cTKA. This was a retrospective cohort cost-analysis study of patients undergoing primary, elective roTKA or cTKA from July 2020 to March 2021. Time-driven activity-based costing (TDABC) was used to determine granular costs. Patient demographics, medical/surgical details, and costs were compared. A total of 2058 TKAs were analyzed (1795 cTKAs and 263 roTKAs). roTKA patients were more often male (50.2% vs 42.3%; P = .016), and discharged home (98.5% vs 93.7%; P = .017), and had longer operating room (OR) time (144.6 vs 130.9 minutes; P < .0001), and lower length of stay (LOS) (1.8 vs 2.1 days; P < .0001). roTKA costs were 2.17× greater for supplies excluding implant (P < .0001), 1.18× for total supplies (P < .0001), 1.12× for OR personnel (P < .0001), and 1.05× for total personnel (P = .0001). Implant costs were similar (P = .076), but 0.98× cheaper for post-anesthesia care unit personnel (P = .018) and 0.84× for inpatient personnel (P < .0001). Overall hospital costs for roTKA were 1.10× more than cTKA (P < .0001). roTKA had higher total hospital costs than cTKA. Despite a lower LOS, the longer OR time with higher supply and personnel costs resulted in a costlier procedure. Understanding the costs of roTKA is essential when considering the value (ie, outcomes per dollars spent) of this modern technology.
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DOI：
10.1007/s00167-018-5138-5
发表时间：
2019-04
期刊：
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
影响因子：
--
作者：
Kayani B;Konan S;Huq SS;Tahmassebi J;Haddad FS
通讯作者：
Haddad FS
影响因子：
5.3
作者：
Carducci, Michael P.;Gasbarro, Gregory;Jawa, Andrew
通讯作者：
Jawa, Andrew
影响因子：
3
作者：
Carducci, Michael P.;Mahendraraj, Kuhan A.;Jawa, Andrew
通讯作者：
Jawa, Andrew
影响因子：
3.5
作者：
Keswani, Aakash;Tasi, Michael C.;Bozic, Kevin J.
通讯作者：
Bozic, Kevin J.
影响因子：
4.2
作者：
Akhavan, Sina;Ward, Lorrayne;Bozic, Kevin J.
通讯作者：
Bozic, Kevin J.