Defining the Cost of Arthroscopic Rotator Cuff Repair: A Multicenter, Time-Driven Activity-Based Costing and Cost...

Area of Science:

• Orthopaedic Surgery
• Health Economics
• Cost Analysis

Background:

• Rotator cuff repair (RCR) is a common outpatient surgery with significant healthcare costs.
• Time-driven activity-based costing (TDABC) offers a detailed method for analyzing healthcare expenses.
• Understanding RCR cost drivers is crucial for strategic financial decision-making.

Purpose of the Study:

• To apply TDABC methodology to RCR procedures.
• To identify strategies for optimizing cost-efficiency in RCR.
• To analyze cost reduction through decreased episode duration and standardized suture anchor acquisition.

Main Methods:

• Multicenter, retrospective study of 921 RCR cases across 4 US academic health systems.
• Data extracted from Avant-Garde Health's Care Measurement platform.
• TDABC methodology used to analyze episode duration costs and suture anchor expenses.

Main Results:

• Mean episode duration cost was $4,094 ± $1,850, with threefold variability (10th percentile $2,282 vs. 90th percentile $6,833).
• Episode duration averaged 7.1 hours, with most variability in post-acute care and ward time.
• Reducing variability could save 640 care-hours annually per hospital; standardizing suture anchors could save $217,440 across institutions.

Conclusions:

• RCR costs are influenced by care pathways and suture anchor expenses.
• Strategies for cost savings include optimizing care duration and standardizing supply costs.
• Findings provide a basis for developing health-economic models for RCR.