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A 90-Day Episode-of-Care Analysis Including Computed Tomography Scans of Robotic-Arm Assisted versus Manual Total Knee Arthroplasty
Journal of Knee Surgery ( IF 1.6 ) Pub Date : 2022-07-11 , DOI: 10.1055/s-0042-1749083
David A Gregory 1 , Andrea Coppolecchia 2 , Dennis J Scotti 3 , Zhongming Chen 4 , Michael A Mont 4 , David Jacofsky 5
Affiliation  

In this observational, retrospective study, we performed economic analyses between robotic arm-assisted total knee arthroplasty (RATKA) and manual total knee arthroplasty (MTKA). Specifically, we compared: (1) index costs including computed tomography (CT) scans; (2) 90-day postoperative health care utilization, (3) 90-day episode-of-care (EOC) costs, and (4) lengths of stay between CT scan-based robotically-assisted versus MTKAs. A large national database, Blue Health Intelligence (BHI), was used for RATKAs and MTKAs performed between April 1, 2017 and September 30, 2019. Based on strict inclusion–exclusion criteria, with propensity score matching, 4,135 RATKAs and 4,135 MTKAs were identified and analyzed. Index costs to the payer for RATKA patients were found to be less than those for MTKA patients ($29,984 vs. $31,280, p <0.0001). Overall, 90-day EOC costs for RATKA patients were found to be less than that for MTKA patients in the inpatient and outpatient settings. This also holds true for the use of skilled nursing facilities, pharmacies, or other services. In conclusion, the results from our study show that RATKA were associated with lower costs than MTKAs, even when including the cost of CT scans. These results are of marked importance given the emphasis to contain and reduce health care costs.



中文翻译:

90 天的护理分析,包括机械臂辅助与手动全膝关节置换术的计算机断层扫描

在这项观察性回顾性研究中,我们对机械臂辅助全膝关节置换术 (RATKA) 和手动全膝关节置换术 (MTKA) 进行了经济分析。具体来说,我们比较了:(1)索引成本,包括计算机断层扫描(CT)扫描;(2) 90 天术后医疗保健利用率,(3) 90 天护理 (EOC) 成本,以及 (4) 基于 CT 扫描的机器人辅助与 MTKA 之间的住院时间。Blue Health Intelligence (BHI) 大型国家数据库用于 2017 年 4 月 1 日至 2019 年 9 月 30 日期间进行的 RATKA 和 MTKA。根据严格的纳入-排除标准,通过倾向评分匹配,确定了 4,135 个 RATKA 和 4,135 个 MTKA并进行了分析。研究发现 RATKA 患者的付款人的指数成本低于 MTKA 患者的指数成本(29,984 美元 vs. 31,280 美元,p <0.0001)。总体而言,在住院和门诊环境中,RATKA 患者的 90 天 EOC 费用低于 MTKA 患者。这也适用于使用熟练的护理设施、药房或其他服务。总之,我们的研究结果表明,RATKA 的成本低于 MTKA,即使包括 CT 扫描的成本也是如此。鉴于控制和降低医疗保健成本的重点,这些结果具有显着的重要性。

更新日期:2022-07-12
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