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A 90-Day Episode-of-Care Cost Analysis of Robotic-Arm Assisted Total Knee Arthroplasty

4 pagesPublished: October 27, 2019

Abstract

Introduction
One way to potentially help contain the rising healthcare costs is the utilization of technological advances, such as robotic-assistive technology, for total knee arthroplasty (TKA). Therefore, the purpose of this study was to perform a cost analysis between robotic-arm assisted TKA and manual TKA (mTKA) techniques. Specifically, we compared: 1) 90-day EOC costs, as well as several variables within the episode, including 2) index costs; 3) index lengths-of-stay (LOS); 4) discharge disposition; and 5) readmission rates.

Methods
A retrospective claims analysis was performed on Medicare FFS beneficiaries who underwent rTKA and mTKA procedures between January 1, 2016 and March 31, 2017. Patients were matched rTKA to mTKA in a 1-to-5 ratio, yielding 519 rTKAs and 2,595 mTKAs. The overall 90-day EOC costs, including the index procedures, LOS, discharge dispositions, and readmissions were compared between cohorts.

Results
Overall 90-day EOC costs ($18,568 vs. $20,960) as well as index facility costs ($12,384 vs. $13,024; p=0.0001) were found to be less than that for rTKA vs. mTKA. rTKA also accrued $1,744 fewer costs than mTKA (5,234 vs. $6,978; p=<0.0001) utilized fewer days in inpatient (4 vs. 7; p<0.0001) and SNF care (15 vs. 16; p=0.0642) as well as a 90-day readmission reduction of 33% (p=0.0423).

Discussion
The results from this study show rTKA to be associated with significantly lower 90-day EOC costs. These lower rTKA patient costs are likely attributable to the significantly lower index costs, increased likelihood of being discharged to home, shorter LOS, and decreased readmission rates, when compared to mTKA patient costs.

Keyphrases: Healthcare costs, Robotic-arm assisted TKA, Surgical technology, TKA

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 76--79

Links:
BibTeX entry
@inproceedings{CAOS2019:90_Day_Episode_of_Care_Cost_Analysis,
  author    = {Christina Cool and David Jacofsky and Kelly Seeger and Andr\textbackslash{}'ea Coppolecchia and Nipun Sodhi and Joseph Ehiorobo and Michael Mont},
  title     = {A 90-Day Episode-of-Care Cost Analysis of Robotic-Arm Assisted Total Knee Arthroplasty},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  pages     = {76--79},
  year      = {2019},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/WQVh},
  doi       = {10.29007/h8xz}}
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