Determinants of hospitalization expenses in primary arthroscopic stabilization for recurrent shoulder anterior...

To identify the factors affecting hospital cost associated with primary arthroscopic stabilization for recurrent shoulder anterior instability. The clinical data of patients with symptoms of recurrent glenohumeral anterior stability who underwent arthroscopic stabilization at a single institution between January 2020 and April 2022 were collected retrospectively. Surgical information and patient characteristics were recorded. Variations in hospital hospitalization expenses were identified and extracted from the medical and billing record keeping system at the hospital. Sixty-one cases of recurrent anterior instability of the glenohumeral joint were identified in 59 patients during the study period. There were no significant differences in hospitalization expenses between the Arthroscopic Bankart repair and Arthroscopic Latarjet groups (P = .624), nor across the different periods (P = .54). However, compared with the minority group, the majority group required a higher number of surgical procedures (1 [1, 1.5] vs 2 [1, 2], P = .011) and had longer operative durations (120.00 [107.00, 135.00] minutes vs 162.50 [130.00, 222.50] minutes, P = .001). Total hospitalization expenses were significantly higher in the majority group (10,144.23 ± 1795.78 United States dollar [USD]) than in the minority group (9042.87 ± 943.22 USD) (P = .003), driven by increased costs for implants (3848.84 ± 855.72 USD vs 4623.81 ± 1175.04 USD, P = .005), consumables (6886.56 ± 1013.82 USD vs 7649.36 ± 1620.16 USD, P = .028), anesthesia (371.98 [357.98, 379.40] USD vs 400.82 [371.98, 429.66] USD, P = .001), medications (524.45 [427.86, 631.29] USD vs 623.39 [515.35, 824.74] USD, P = .02), and anesthetics (168.83 ± 44.55 USD vs 213.83 ± 66.82 USD, P = .003). No significant differences were observed between the minority and majority groups in operation expenses, non-implanted consumables, perioperative drug costs, nursing and examination fees, or days of hospitalization (all P > .05). Patients who experienced 3 or more recurrent dislocations prior to primary arthroscopic stabilization incurred significantly higher hospitalization expenses, driven by increased implant use and prolonged operative time. These findings suggest that earlier surgical intervention in patients with recurrent anterior shoulder instability may help reduce procedural complexity and associated costs.