Transparency to Reduce Surgical Implant Waste

BACKGROUND: Rising health care costs and emphasis on value have placed the onus of reducing healthcare costs on the surgeon. METHODS: Financial data from 3,973 hip, knee, and shoulder arthroplasties performed at a physician owned orthopedic hospital was retrospectively reviewed over a two-year period. A wasted implant financial report was posted starting the second year of the study. Each surgeon's performance could be identified by his peers. RESULTS: After posting of the financial report, 1.11% of all hip and knee arthroplasty cases had a waste event compared to 1.50% during the control year. Shoulder arthroplasty waste events occurred twice as often than that observed in hip and knee arthroplasty during the study period. A decrease in waste events was observed but was not statistically significant (p = 0.30). CONCLUSIONS: Posting a non-blinded wasted implant data sheet was associated with a reduction in the number of wasted orthopedic surgical implants in this series, although the reduction was not statistically significant.

Artroplastia do quadril: análise dos custos e benefícios / Total hip replacement: analysis of cost/benefits

Foram analisados os prontuários de 62 pacientes submetidos a artroplastias do quadril, no Hospital das Clínicas - UFPE, no período de 1988 a 1991, objetivando-se fazer um estudo crítico dos resultados e avaliar a relaçäo custo benefício. Dezenove pacientes foram entrevistados para se conhecer os graus de informaçäo e satisfaçäo obtidos com o tratamento e submetidos a aavaliaçäo clínico-funcional pós-operatória. Os resultados mostram que 63 por cento dos pacientes demonstraram excelente ou bom grau de informaçäo/satisfaçäo e 59 por cento obtiveram bom resultado clínico-funcional. O custo médio das despesas hospitalares, por pacientes, foi de U$ 1.857,00 e a dos gastos com os implantes foi de U$ 3.177,00 . O tempo médio de internaçäo foi de 28 dias. Apesar do custo elevado total, quando comparado á realidade econômica e social da regiäo NE e do longo tempo de internaçäo, tais cirurgias constituiram-se em boas opçöes para a maioria dos pacientes estudados