Evaluation of Costs Associated With Acute Achilles Tendon Repair
Background: Increasing attention is being paid to the costs associated with various orthopaedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears. Methods: We retrospectively identified patients with surgically repaired acute...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-03-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114241238215 |
| _version_ | 1827313527581310976 |
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| author | Kade Wagers MK Blessing S. Ofori-Atta MS William Tucker MD Angela P. Presson PhD Devon Nixon MD |
| author_facet | Kade Wagers MK Blessing S. Ofori-Atta MS William Tucker MD Angela P. Presson PhD Devon Nixon MD |
| author_sort | Kade Wagers MK |
| collection | DOAJ |
| description | Background: Increasing attention is being paid to the costs associated with various orthopaedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears. Methods: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture detailed cost data—costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% CIs. Results: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on surgical positioning (prone n = 156, supine n = 68). Open repairs (n = 215), compared with percutaneous techniques (n = 9) that used commercially available instrumentation, had 37% less total direct costs ( P < .001, 95% CI 0.55-0.72). Compared with surgery at a main academic hospital (n = 15), procedures at an ambulatory care center (n = 207) had 19% lower total direct costs ( P = .040, 95% CI 0.66-0.99) and 41% lower facility costs ( P < .001, 95% CI 0.5-0.7). Conclusion: Improving cost-effective orthopaedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful impacts on cost. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs. Level of Evidence: Level III, retrospective comparative study. |
| first_indexed | 2024-04-24T22:10:17Z |
| format | Article |
| id | doaj.art-4d1f177d58b24ac4a1065c5977456e09 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-24T22:10:17Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-4d1f177d58b24ac4a1065c5977456e092024-03-20T10:03:27ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-03-01910.1177/24730114241238215Evaluation of Costs Associated With Acute Achilles Tendon RepairKade Wagers MK0Blessing S. Ofori-Atta MS1William Tucker MD2Angela P. Presson PhD3Devon Nixon MD4Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT, USADivision of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USADepartment of Orthopedic Surgery, University of Utah, Salt Lake City, UT, USADivision of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USADepartment of Orthopedic Surgery, University of Utah, Salt Lake City, UT, USABackground: Increasing attention is being paid to the costs associated with various orthopaedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears. Methods: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture detailed cost data—costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% CIs. Results: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of 4 fellowship-trained orthopaedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on surgical positioning (prone n = 156, supine n = 68). Open repairs (n = 215), compared with percutaneous techniques (n = 9) that used commercially available instrumentation, had 37% less total direct costs ( P < .001, 95% CI 0.55-0.72). Compared with surgery at a main academic hospital (n = 15), procedures at an ambulatory care center (n = 207) had 19% lower total direct costs ( P = .040, 95% CI 0.66-0.99) and 41% lower facility costs ( P < .001, 95% CI 0.5-0.7). Conclusion: Improving cost-effective orthopaedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful impacts on cost. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs. Level of Evidence: Level III, retrospective comparative study.https://doi.org/10.1177/24730114241238215 |
| spellingShingle | Kade Wagers MK Blessing S. Ofori-Atta MS William Tucker MD Angela P. Presson PhD Devon Nixon MD Evaluation of Costs Associated With Acute Achilles Tendon Repair Foot & Ankle Orthopaedics |
| title | Evaluation of Costs Associated With Acute Achilles Tendon Repair |
| title_full | Evaluation of Costs Associated With Acute Achilles Tendon Repair |
| title_fullStr | Evaluation of Costs Associated With Acute Achilles Tendon Repair |
| title_full_unstemmed | Evaluation of Costs Associated With Acute Achilles Tendon Repair |
| title_short | Evaluation of Costs Associated With Acute Achilles Tendon Repair |
| title_sort | evaluation of costs associated with acute achilles tendon repair |
| url | https://doi.org/10.1177/24730114241238215 |
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