Abstract
Compared with traditional open arthrodesis, arthroscopic ankle arthrodesis has been
associated with similar rates of fusion, decreased time to union, decreased pain,
shorter hospital stay, earlier mobilization, reliable clinical results, and fewer
complications. The aim of this case-control study was to analyze cost differences
between outpatient arthroscopic and inpatient open ankle arthrodesis. To this end,
the authors analyzed 20 ankle arthrodesis procedures: 10 performed by one surgeon
on an inpatient basis using an open approach, and 10 performed by another surgeon
on an outpatient basis arthroscopically. Patient age, body mass index, tourniquet
time, length of stay, complications, days to clinical union, and insurance type, as
well as charges and reimbursements for the surgeons and the hospital or surgery center
were abstracted from the records. Statistically significant differences were observed
between the outpatient arthroscopic and inpatient open arthrodesis groups for total
site charges ($3898 ± 0.00 versus $32,683 ± $12,762, respectively, P < .0001), reimbursement to the surgeon ($1567 ± $320 versus $1107 ± $278, respectively,
P = .003), and reimbursement to the hospital or ambulatory surgery center ($1110 ±
$287 versus $8432 ± $2626, respectively); the ratio of hospital/surgery center charges
to hospital/surgery center reimbursements was 28.48% for the inpatient arthroscopic
group and 25.80% for the inpatient open arthrodesis group. Outpatient arthroscopic
ankle arthrodesis, compared with inpatient open ankle arthrodesis, appears to be less
expensive for third party payers, and surgeons are paid more, whereas hospitals and
ambulatory surgical centers get paid a greater proportion of the charges that they
bill.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
