Robotic Versus Manual Total Hip Arthroplasty: A Marginal Time-driven Activity-based Costing Analysis

Area of Science:

• Orthopedic Surgery
• Health Economics
• Medical Technology Assessment

Background:

• Standard cost analyses for robotic total hip arthroplasty (THA) exist.
• No studies have utilized time-driven activity-based costing (TDABC) for robotic THA cost analysis.
• TDABC offers a more accurate reflection of healthcare resource utilization.

Purpose of the Study:

• To compare healthcare facility costs between robotic and manual THA.
• To apply the novel TDABC method for cost calculation in THA.
• To assess the economic feasibility of robotic THA.

Main Methods:

• Retrospective analysis of 384 THAs (2019-2023).
• Calculation of total healthcare facility costs (personnel and supply) using TDABC.
• Multiple regression analysis to determine the effect of robotic assistance on costs, with and without implant costs.

Main Results:

• Robotic THA showed a shorter length of stay but similar surgical times and personnel costs.
• Robotic THA had higher initial supply and facility costs, with and without implant costs.
• After controlling for demographics and comorbidities, total facility costs were similar between robotic and manual THA.

Conclusions:

• TDABC reveals comparable healthcare facility costs for robotic and manual THA when controlling for influencing variables.
• The study provides patient-level cost data on the economic viability of robotic THA.
• Further research on long-term outcomes is necessary to fully determine the advantages of robotic THA.