Avant-Garde & Codman Shoulder Society Multicenter Cost-Analysis of Arthroscopic Rotator Cuff Repair
Updated: 21 minutes ago
Dear Colleagues:
Enclosed is a recent collaborative study of AVGH & CSS. The title of this work is “Defining the Cost of Arthroscopic Rotator Cuff Repair.” The primary author here is Dr. Catherine J. Fedorka though this is a collaboration of many across four hospital systems. The conclusions are clear: True cost savings can be achieved by managing the length of the episode of care and the suture anchors used for repair. While this study did not analyze outcome, it is likely that such modifications in care are unlikely to affect such outcome.
This work builds on our prior publication by O’Donnell and colleagues: "Surgeon idiosyncrasy is a key driver of cost in arthroscopic rotator cuff repair: a time-driven activity-based costing analysis."
The bottom line is that a high degree of cost variability exists among physicians which cannot be explained by factors such as complexity and tear size. Standardization of care which results in thoughtful stewardship of resources, both time and implants, offers a real opportunity to create value.
Finally, this study does not comment on the method by which to change surgeon behavior. It seems logical to assume that behavioral economics is probably better served by motivating with a “carrot and not a stick.” Thus, some form of gainsharing which returns value to physicians and/or their department is most likely to result in meaningful behavior change which leads to lower costs.
Kind Regards,
Jon “JP” Warner MD
Founder, CSS
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