Timothy B Alton, Abhishek S Chitnis, Laura Goldstein, Sidharth Kovilakam Rajappan, Anshu Gupta, Kristian Michnacs, Chantal E Holy, Daniel P Hoeffel
{"title":"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。","authors":"Timothy B Alton, Abhishek S Chitnis, Laura Goldstein, Sidharth Kovilakam Rajappan, Anshu Gupta, Kristian Michnacs, Chantal E Holy, Daniel P Hoeffel","doi":"10.1080/17434440.2023.2185135","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Research design and methods: </strong>Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA (\"index') in the in- or outpatient setting for knee osteoarthritis between Oct 1<sup>st</sup>, 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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Cost-neutrality of rTKA vs. mTKA was observed, with a potential for lowered immediate post-operative HCU in the rTKA vs. mTKA cohorts.</p>","PeriodicalId":12330,"journal":{"name":"Expert Review of Medical Devices","volume":"20 4","pages":"303-311"},"PeriodicalIF":2.9000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Resource utilization and costs for robotic-assisted and manual total knee arthroplasty - a premier healthcare database study.\",\"authors\":\"Timothy B Alton, Abhishek S Chitnis, Laura Goldstein, Sidharth Kovilakam Rajappan, Anshu Gupta, Kristian Michnacs, Chantal E Holy, Daniel P Hoeffel\",\"doi\":\"10.1080/17434440.2023.2185135\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Research design and methods: </strong>Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA (\\\"index') in the in- or outpatient setting for knee osteoarthritis between Oct 1<sup>st</sup>, 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.</p><p><strong>Results: </strong>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). 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Resource utilization and costs for robotic-assisted and manual total knee arthroplasty - a premier healthcare database study.
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.
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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