Resource utilization and costs for robotic-assisted and manual total knee arthroplasty - a premier healthcare database study.

IF 2.9 3区 医学 Q3 ENGINEERING, BIOMEDICAL Expert Review of Medical Devices Pub Date : 2023-04-01 DOI:10.1080/17434440.2023.2185135
Timothy B Alton, Abhishek S Chitnis, Laura Goldstein, Sidharth Kovilakam Rajappan, Anshu Gupta, Kristian Michnacs, Chantal E Holy, Daniel P Hoeffel
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Abstract

Introduction: The impact of robotic-assisted total knee arthroplasty (rTKA) vs. traditional, manual TKA (mTKA) on hospital costs is not well documented and is analyzed herein.

Research design and methods: Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA ("index') in the in- or outpatient setting for knee osteoarthritis between Oct 1st, 2015, to September 30th, 2021, were identified. Variables included patient demographics and comorbidities and hospital characteristics. Matched rTKA vs. mTKA cohorts were created using direct (on provider characteristics, age, gender, race and Elixhauser index) and propensity score matching (fixation type, comorbidities). Index and 90-day inflation-adjusted costs and healthcare utilization (HCU) were analyzed for both cohorts, using generalized linear models.

Results: 16,714 rTKA patients were matched to 51,199 mTKA patients. Average 90-day hospital cost reached $17,932 and were equivalent for both cohorts (rTKA vs. mTKA: $132 (95% confidence interval; -$19 to $284). There was a 2.7% (95%CI: 2.2%-3.3%) increase in home or home health discharge, and a 0.4% (95%CI: 0%-0.8%) decrease in 90-day hospital knee related re-visit in the rTKA vs. mTKA group.

Conclusions: Cost-neutrality of rTKA vs. mTKA was observed, with a potential for lowered immediate post-operative HCU in the rTKA vs. mTKA cohorts.

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机器人辅助和人工全膝关节置换术的资源利用和成本——一项重要的医疗数据库研究。
机器人辅助全膝关节置换术(rTKA)与传统的人工全膝关节置换术(mTKA)对医院成本的影响尚未得到很好的记录,本文将对此进行分析。研究设计和方法:在2015年10月1日至2021年9月30日期间,在Premier billing Healthcare Database中接受选择性rTKA或mTKA(“index”)治疗膝骨关节炎的住院或门诊患者被确定。变量包括患者人口统计、合并症和医院特征。使用直接(提供者特征、年龄、性别、种族和Elixhauser指数)和倾向评分匹配(固定类型、合并症)创建匹配的rTKA与mTKA队列。使用广义线性模型分析两个队列的指数和90天通货膨胀调整成本和医疗保健利用率(HCU)。结果:16714例rTKA患者与51199例mTKA患者匹配。平均90天住院费用达到17,932美元,两个队列的费用相等(rTKA vs. mTKA: 132美元;- 19至284美元)。与mTKA组相比,rTKA组家庭或家庭健康出院率增加2.7% (95%CI: 2.2%-3.3%), 90天医院膝关节相关再访率减少0.4% (95%CI: 0%-0.8%)。结论:观察到rTKA与mTKA的成本中性,rTKA与mTKA队列具有降低术后立即HCU的潜力。
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来源期刊
Expert Review of Medical Devices
Expert Review of Medical Devices 医学-工程:生物医学
CiteScore
5.90
自引率
3.20%
发文量
69
审稿时长
6-12 weeks
期刊介绍: The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.
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