PDF(Pubmed)
Abstract：
UNASSIGNED: Increasing attention is being paid to the costs associated with various orthopaedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears.
UNASSIGNED: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture detailed cost data-costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% CIs.
UNASSIGNED: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on surgical positioning (prone n = 156, supine n = 68). Open repairs (n = 215), compared with percutaneous techniques (n = 9) that used commercially available instrumentation, had 37% less total direct costs (P < .001, 95% CI 0.55-0.72). Compared with surgery at a main academic hospital (n = 15), procedures at an ambulatory care center (n = 207) had 19% lower total direct costs (P = .040, 95% CI 0.66-0.99) and 41% lower facility costs (P < .001, 95% CI 0.5-0.7).
UNASSIGNED: Improving cost-effective orthopaedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful impacts on cost. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs.
UNASSIGNED: Level III, retrospective comparative study.
UNASSIGNED: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture detailed cost data-costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% CIs.
UNASSIGNED: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on surgical positioning (prone n = 156, supine n = 68). Open repairs (n = 215), compared with percutaneous techniques (n = 9) that used commercially available instrumentation, had 37% less total direct costs (P < .001, 95% CI 0.55-0.72). Compared with surgery at a main academic hospital (n = 15), procedures at an ambulatory care center (n = 207) had 19% lower total direct costs (P = .040, 95% CI 0.66-0.99) and 41% lower facility costs (P < .001, 95% CI 0.5-0.7).
UNASSIGNED: Improving cost-effective orthopaedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful impacts on cost. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs.
UNASSIGNED: Level III, retrospective comparative study.
摘要：
■越来越关注与各种骨科手术相关的成本。这里,我们研究了影响手术治疗急性跟腱撕裂相关费用的因素.
■我们回顾性地确定了手术修复急性跟腱撕裂的患者，排除插入性断裂或慢性肌腱问题。使用我们机构的价值驱动成果(VDO)工具，我们评估了总直接成本和设施成本。简而言之，VDO工具包括一个项目级数据库，该数据库可以捕获详细的成本数据-然后将成本报告为相对平均数据。成本变量调整为2022年美元，使用伽马回归将总直接成本与患者特征进行比较,以报告95%CI的成本比。
■我们的队列包括224例跟腱撕裂患者，这些患者是由4名经研究资格训练的足踝外科医师之一手术修复的。人口统计学没有差异，直接总成本，或基于手术定位的设施成本(俯卧n=156，仰卧n=68)。开放式维修(n=215),与使用市售仪器的经皮技术(n=9)相比，总直接费用减少37%（P<.001，95%CI0.55-0.72）。与主要学术医院的手术相比(n=15)，门诊护理中心(n=207)的手术总直接费用降低19%(P=.040,95%CI0.66-0.99),设施费用降低41%(P<.001,95%CI0.5-0.7).
■改善具有成本效益的骨科护理仍然是一个越来越重要的目标。跟腱修复的患者定位似乎不会对成本产生有意义的影响。在临床上适当的时候，在门诊中心考虑手术位置似乎可以降低手术成本。
■三级,回顾性比较研究。
■我们回顾性地确定了手术修复急性跟腱撕裂的患者，排除插入性断裂或慢性肌腱问题。使用我们机构的价值驱动成果(VDO)工具，我们评估了总直接成本和设施成本。简而言之，VDO工具包括一个项目级数据库，该数据库可以捕获详细的成本数据-然后将成本报告为相对平均数据。成本变量调整为2022年美元，使用伽马回归将总直接成本与患者特征进行比较,以报告95%CI的成本比。
■我们的队列包括224例跟腱撕裂患者，这些患者是由4名经研究资格训练的足踝外科医师之一手术修复的。人口统计学没有差异，直接总成本，或基于手术定位的设施成本(俯卧n=156，仰卧n=68)。开放式维修(n=215),与使用市售仪器的经皮技术(n=9)相比，总直接费用减少37%（P<.001，95%CI0.55-0.72）。与主要学术医院的手术相比(n=15)，门诊护理中心(n=207)的手术总直接费用降低19%(P=.040,95%CI0.66-0.99),设施费用降低41%(P<.001,95%CI0.5-0.7).
■改善具有成本效益的骨科护理仍然是一个越来越重要的目标。跟腱修复的患者定位似乎不会对成本产生有意义的影响。在临床上适当的时候，在门诊中心考虑手术位置似乎可以降低手术成本。
■三级,回顾性比较研究。
