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Arthroplasty implants and materials: Cost awareness and value perception.

Mursal Gardezi¹, Taylor D Ottesen¹, Vineet Tyagi²

¹Yale School of Medicine, New Haven, CT, United States of America.

|July 26, 2021

Summary

Surgical teams often overestimate implant costs and value in joint arthroplasty. While attendings are willing to use cheaper options, many support staff hesitate, indicating a knowledge gap in cost differences.

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Area of Science:

Orthopedic Surgery
Health Economics
Medical Device Technology

Background:

Arthroplasty procedures represent a significant portion of US healthcare expenditures.
Surgical teams may select implants and materials without full cost awareness.
Understanding cost perceptions is crucial for managing healthcare spending in joint replacements.

Purpose of the Study:

To investigate the perceptions of academic surgical teams regarding the relative cost and value of common operating room implants used in arthroplasty.
To identify knowledge gaps and potential barriers to adopting cost-effective options in joint arthroplasty.

Main Methods:

A survey was administered to 102 surgical team members (attendings, fellows, residents, PAs, APRNs, RNs) from an academic group.
Respondents evaluated 10 matched pairs of commonly used arthroplasty implants and materials based on perceived cost and value.
Statistical analysis was performed on response accuracy and perceptions of cost differences and clinical value.

Main Results:

Respondents correctly identified the more expensive item in 90.2% of cases, but significantly overestimated cost differences for 8 out of 10 pairs.
A majority perceived higher cost items as having higher clinical value for 9 out of 10 pairs.
While most attendings (91.3%) would use less expensive options, 17.9% of other staff felt uncomfortable suggesting them.

Conclusions:

A significant knowledge deficit exists among surgical teams regarding the actual cost differences of arthroplasty implants.
Perceptions of cost and clinical value are often misaligned, with a bias towards more expensive items.
Hesitancy among non-attending surgical staff to suggest less expensive options highlights a need for education and improved cost awareness in arthroplasty settings.