Time-driven activity-based cost of outpatient total hip and knee arthroplasty in different set-ups
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Time-driven activity-based cost of outpatient total hip and knee arthroplasty in different set-ups. / Husted, Henrik; Kristensen, Billy B; Andreasen, Signe E; Skovgaard Nielsen, Christian; Troelsen, Anders; Gromov, Kirill.
I: Acta Orthopaedica, Bind 89, Nr. 5, 2018, s. 515-521.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Time-driven activity-based cost of outpatient total hip and knee arthroplasty in different set-ups
AU - Husted, Henrik
AU - Kristensen, Billy B
AU - Andreasen, Signe E
AU - Skovgaard Nielsen, Christian
AU - Troelsen, Anders
AU - Gromov, Kirill
PY - 2018
Y1 - 2018
N2 - Background and purpose - Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced over the years due to fast-track. Short stays of 2 days in fast-track departments in Denmark have resulted in low total costs of around US$2,550. Outpatient THA and TKA is gaining popularity, albeit in a limited and selected group of patients; however, the financial benefit of outpatient arthroplasty remains unknown. We present baseline detailed economic calculations of outpatient THA and TKA in 2 different settings: one from the hospital and another from the ambulatory surgery department. Patients and methods - Data from 6 patients (1 TKA, 1 uncemented THA, 1 cemented THA in each department) were collected prospectively using the Time Driven Activity Based Costing method (TDABC). Time consumed by different staff members involved in patient treatment in the perioperative period of outpatient THA and TKA was calculated in 2 different settings: one in the orthopedic department and one in the ambulatory surgery department. Results - LOS was around 11 h in the orthopedic department and around 7 h in the ambulatory surgery department, respectively. TDABC revealed minor differences in the operative settings between departments and similar expenses occurred during the short stay of US$777 and US$746, respectively. Adding the preoperative preparation and postoperative follow-up resulted in total cost of US$951 and US$942 for the ward and the ambulatory surgery department, respectively. Interpretation - Outpatient THA and TKA in hospital and ambulatory surgery departments results in similar cost using the TDABC method. Compared with the cost associated with 2-day stays, outpatient procedures are around two-thirds cheaper provided no increase occurs in complications or readmissions.
AB - Background and purpose - Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced over the years due to fast-track. Short stays of 2 days in fast-track departments in Denmark have resulted in low total costs of around US$2,550. Outpatient THA and TKA is gaining popularity, albeit in a limited and selected group of patients; however, the financial benefit of outpatient arthroplasty remains unknown. We present baseline detailed economic calculations of outpatient THA and TKA in 2 different settings: one from the hospital and another from the ambulatory surgery department. Patients and methods - Data from 6 patients (1 TKA, 1 uncemented THA, 1 cemented THA in each department) were collected prospectively using the Time Driven Activity Based Costing method (TDABC). Time consumed by different staff members involved in patient treatment in the perioperative period of outpatient THA and TKA was calculated in 2 different settings: one in the orthopedic department and one in the ambulatory surgery department. Results - LOS was around 11 h in the orthopedic department and around 7 h in the ambulatory surgery department, respectively. TDABC revealed minor differences in the operative settings between departments and similar expenses occurred during the short stay of US$777 and US$746, respectively. Adding the preoperative preparation and postoperative follow-up resulted in total cost of US$951 and US$942 for the ward and the ambulatory surgery department, respectively. Interpretation - Outpatient THA and TKA in hospital and ambulatory surgery departments results in similar cost using the TDABC method. Compared with the cost associated with 2-day stays, outpatient procedures are around two-thirds cheaper provided no increase occurs in complications or readmissions.
KW - Ambulatory Surgical Procedures/economics
KW - Arthroplasty, Replacement, Hip/economics
KW - Arthroplasty, Replacement, Knee/economics
KW - Denmark
KW - Health Care Costs/statistics & numerical data
KW - Humans
KW - Length of Stay/statistics & numerical data
KW - Perioperative Care/economics
KW - Prospective Studies
U2 - 10.1080/17453674.2018.1496309
DO - 10.1080/17453674.2018.1496309
M3 - Journal article
C2 - 30078348
VL - 89
SP - 515
EP - 521
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
IS - 5
ER -
ID: 218434816