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Perioperative Operating Room Efficiency Can Make Simultaneous Bilateral Total Hip Arthroplasty Cost-effective: A
Jeroen C F Verhaegen1,2,3, Alexina Schreiber4, Clara Balust4
1Hip Unit, Orthopaedic Department, Ziekenhuis Oost-Limburg, Genk, Belgium.
Arthroplasty Today
|December 23, 2022
Summary
Simultaneous bilateral total hip arthroplasty (THA) is more cost-effective than staged unilateral procedures when operating room efficiency strategies are implemented. This approach saves time and reduces costs, benefiting both hospitals and surgeons.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Operating Room Management
Background:
- Rising demand for total hip arthroplasty (THA) and increasing healthcare costs necessitate improved operating room (OR) efficiency.
- Hospitals are exploring strategies to optimize OR workflows and reduce procedural costs.
Purpose of the Study:
- To compare the cost-effectiveness of simultaneous bilateral THA versus staged unilateral THA.
- To evaluate the impact of OR efficiency strategies on the economic outcomes of THA procedures.
Main Methods:
- A retrospective analysis of 446 simultaneous and 238 staged bilateral primary THA patients between 2017-2019.
- Prospective cost-effectiveness comparison of 16 simultaneous and 34 unilateral THAs using detailed timestamp and resource usage data.
- Assessment of outcomes based on complication rates, reoperation rates, and patient-reported outcome measures.
Main Results:
- No significant difference in complication rates between simultaneous (1.1%) and staged (1.3%) THA groups (P = .386).
- Mean OR time was significantly lower for simultaneous bilateral THA (109.4 min) compared to two unilateral THAs (133.8 min) (P < .001).
- An 18% time saving and 14% cost saving per procedure were achieved with simultaneous bilateral THA.
Conclusions:
- Implementing OR efficiency strategies enhances the cost-effectiveness of simultaneous bilateral THA compared to staged unilateral procedures.
- A value-sharing model, where cost savings are shared with surgeons, can align incentives and further improve efficiency.
