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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Direct Cost Analysis of Outpatient Arthroscopic Rotator Cuff Repair in Medicare and Non-Medicare Populations
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Direct Cost Analysis of Outpatient Arthroscopic Rotator Cuff Repair in Medicare and Non-Medicare Populations

机译：Medicare和非Medicare人群门诊关节镜肩袖修复的直接成本分析

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Background: Providing high-quality care while also containing cost is a paramount goal in orthopaedic surgery. Increasingly, insurance providers in the United States, including government payers, are requiring financial and performance accountability for episodes of care, including a push toward bundled payments. Hypothesis: The direct cost of outpatient arthroscopic rotator cuff repair was assessed to determine whether, due to an older population, rotator cuff surgery was more costly in Medicare-insured patients than in patients covered by other insurers. We hypothesized that operative time, implant cost, and overall higher cost would be observed in Medicare patients. Study Design: Cohort study; Level of evidence, 3. Methods: Billing and operative reports from 184 outpatient arthroscopic rotator cuff repairs performed by 5 fellowship-trained arthroscopic surgeons were reviewed. Operative time, number and cost of implants, hospital reimbursement, surgeon reimbursement, and insurance type were determined from billing records and operative reports. Patients were stratified by payer (Medicare vs non-Medicare), and these variables were compared. Results: There were no statistically significant differences in the number of suture anchors used, implant cost, surgical duration, or overall cost of arthroscopic rotator cuff repair between Medicare and other insurers. Reimbursement was significantly higher for other payers when compared with Medicare, resulting in a mean per case deficit of $263.54 between billing and reimbursement for Medicare patients. Conclusion: Operating room time, implant cost, and total procedural cost was the same for Medicare patients as for patients with private payers. Further research needs to be conducted to understand the patient-specific factors that affect the cost of an episode of care for rotator cuff surgery.
机译：背景：在提供高质量护理的同时还控制成本是骨科手术的首要目标。在美国，包括政府付款人在内的保险提供商越来越多地要求对护理事件进行财务和绩效问责，包括推动捆绑式付款。假设：评估了门诊关节镜检查肩袖修复的直接费用，以确定由于人口老龄化，医疗保险参保患者的肩袖手术是否比其他保险公司承保的费用更高。我们假设在Medicare患者中会观察到手术时间，植入物成本和总体较高的成本。研究设计：队列研究;证据等级，3。方法：审查了由5名经过研究金培训的关节镜外科医师进行的184例门诊关节镜转子袖修复手术的账单和手术报告。从开票记录和手术报告中确定手术时间，植入物的数量和成本，医院报销，外科医生报销以及保险类型。按付款人对患者进行分类（医疗保险与非医疗保险），并比较这些变量。结果：Medicare与其他保险公司之间在使用的缝合锚钉数量，植入物成本，手术时间或关节镜旋转袖套修复的总成本上无统计学差异。与Medicare相比，其他付款人的报销明显更高，导致Medicare患者的账单与报销之间的每例平均赤字263.54美元。结论：Medicare患者的手术室时间，植入物成本和总手术成本与私人付款人的相同。需要进行进一步的研究来了解影响肩袖手术护理费用的患者特异性因素。

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