Cost-effectiveness of closed-incision negative pressure therapy in primary total joint arthroplasty: a break-even analysis.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-08-01 DOI:10.12968/jowc.2022.0134

Andrew J Luzzi, William K Crockatt, Xavier Ferrer, Jennifer A Kunes, Roshan P Shah, Jeffrey A Geller, H John Cooper

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Abstract

Objective: Surgical site complications (SSCs) are the leading cause of unplanned emergency department visits and readmissions following total joint arthroplasty (TJA). The use of closed-incision negative pressure therapy (ciNPT) has shown promise in reducing SSC occurrence. However, no study has evaluated the cost-effectiveness of ciNPT in primary TJA. The purpose of this study was to calculate the break-even absolute risk reduction (ARR) of SSCs, the break-even treatment cost of SSCs, and the break-even cost-of-use for ciNPT, based on existing literature to assess the cost-effectiveness of ciNPT in primary TJA.

Method: Relevant values for ARR, infection treatment cost and intervention cost were obtained via literature review. A break-even analysis was conducted to investigate the cost-effectiveness of ciNPT use in primary TJA, as well as to derive the ARR, infection treatment cost (C_t) and intervention protocol cost (C_p) values at which ciNPT use becomes cost-effective.

Results: The values derived from the literature review were as follows: C_p=$160.76 USD; C_t=$5348.78 USD; ARR=0.0375. The break-even ARR was calculated to be 3.0%, the break-even C_p was calculated to be $200.58 USD, and the break-even C_t was calculated to be $4286.93 USD. The ARR of ciNPT use was greater than the calculated break-even ARR.

Conclusion: This analysis demonstrated that ciNPT use in primary TJA was cost-effective. By examining the difference between the calculated break-even C_p and the C_p reported in the literature, the cost saved per patient treated with ciNPT can be calculated to be $39.82 USD.

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闭合切口负压疗法在初级全关节成形术中的成本效益：盈亏平衡分析。

目的：手术部位并发症（SSC）是全关节置换术（TJA）后非计划急诊就诊和再住院的主要原因。使用闭合切口负压疗法（ciNPT）有望减少 SSC 的发生。然而，目前还没有研究对闭合切口负压疗法在初级 TJA 中的成本效益进行评估。本研究的目的是根据现有文献，计算 SSCs 的盈亏平衡绝对风险降低率 (ARR)、SSCs 的盈亏平衡治疗成本以及 ciNPT 的盈亏平衡使用成本，以评估 ciNPT 在原发性 TJA 中的成本效益：方法：通过文献综述获得 ARR、感染治疗成本和干预成本的相关数值。方法：通过文献综述获得 ARR、感染治疗成本和干预成本的相关值，并进行盈亏平衡分析，以研究在初治 TJA 中使用 ciNPT 的成本效益，以及得出 ARR、感染治疗成本 (Ct) 和干预方案成本 (Cp) 值，在这些值上使用 ciNPT 才具有成本效益：结果：文献综述得出的数值如下：Cp=160.76 美元；Ct=5348.78 美元；ARR=0.0375。计算得出的盈亏平衡 ARR 为 3.0%，盈亏平衡 Cp 为 200.58 美元，盈亏平衡 Ct 为 4286.93 美元。使用 ciNPT 的 ARR 大于计算出的盈亏平衡 ARR：该分析表明，在初次 TJA 中使用 ciNPT 具有成本效益。通过研究计算出的盈亏平衡 Cp 与文献报道的 Cp 之间的差异，可以计算出每位接受 ciNPT 治疗的患者节省的成本为 39.82 美元。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.