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 approach to analyzing healthcare expenses.
• Understanding cost drivers in RCR 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 focus on reducing episode duration variability and standardizing suture anchor costs.

Main Methods:

• A multicenter, retrospective study of 921 RCR cases across 4 US academic tertiary health systems.
• Data analyzed using TDABC methodology from Avant-Garde Health's Care Measurement platform.
• Cost analysis focused on episode duration variability and suture anchor acquisition costs.

Main Results:

• Mean episode duration cost was $4,094 ± $1,850, with threefold variability between the 10th and 90th percentiles.
• Episode duration averaged 7.1 hours, with significant time spent in post-acute care and wards.
• 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 and operational efficiency in RCR are identified.
• Findings provide a basis for developing health-economics models for RCR.