Procedural factors drive operative costs in arthroscopic rotator cuff repair
Published results showed procedural factors were the most significant drivers of operative costs in arthroscopic rotator cuff repair, while no correlation was found with patient-level factors besides lower charges with women.
Greg L. Cvetanovich, MD, and colleagues collected patient- and procedure-level factors among 712 patients who underwent arthroscopic rotator cuff repair between November 2016 and July 2019 at an ASC to identify intraoperative drivers of cost. Researchers analyzed age, sex, insurance type, American Society of Anesthesiologists grade and Charlson comorbidity index as patient-level factors, while procedure-level factors included use of biologics, anesthesia type, number of anchors and sutures, additional procedures and operative time. Researchers used multivariate linear regression analysis to identify factors significantly associated with higher or lower charges.
Researchers found risk-adjusted operative charges of $19,728, with the factors included predicting nearly 65% of the variability in operative charges. Results showed female sex was the only patient-level factor significantly associated with lower charges. Use of biologics, concurrent open biceps tenodesis, distal clavicle resection, use of regional block, number of anchors and increased operative time were procedure-level factors significantly associated with higher charges, according to results. Researchers noted other factors had no significant association.
“With the increasing focus on evidence-based and value-based medicine, it is important for surgeons performing rotator cuff repairs to consider when these more expensive interventions are necessary to achieve the best patient outcomes and balance these with increased operative cost,” Cvetanovich told Healio Orthopedics. “Furthermore, research should continue to investigate how these interventions impact clinical outcomes, rotator cuff repair healing rates and cost-effectiveness of emerging biologic augmentation techniques.”