RESUMO
PURPOSE: The purpose of this study was to compare the costs associated with anterior cruciate ligament (ACL) reconstruction with either bone-patellar tendon-bone (BPTB) autograft or BPTB allograft. METHODS: Surgical costs are reported, including supply costs, based on invoice costs per item used per procedure, and personnel costs calculated as cost per minute. All operations were performed at an ambulatory surgery center between March 2005 and March 2006. A total of 160 patients underwent primary ACL reconstruction with either BPTB autograft (n = 106) or BPTB allograft (n = 54). Procedure cost data were retrieved from a financial management database and divided into various categories for comparison of the 2 groups. Payment data were provided by the surgery center's billing office. RESULTS: The total mean cost per case was $4,147 ± $943 in the allograft group compared with $3,154 ± $704 in the autograft group; this was statistically significant (P < .001). The mean operating room time was 12 minutes greater in autograft cases (P = .006). Supply costs comprised a mean of 58.7% of total expenses in the autograft group and 72.2% in the allograft group. CONCLUSIONS: Allograft reconstruction of the ACL was significantly more expensive than autograft reconstruction. LEVEL OF EVIDENCE: Level II, economic analysis.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/economia , Artroscopia/economia , Enxerto Osso-Tendão Patelar-Osso/economia , Adolescente , Adulto , Procedimentos Cirúrgicos Ambulatórios/economia , Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Artroscopia/métodos , Custos e Análise de Custo , Feminino , Humanos , Masculino , Meniscos Tibiais/diagnóstico por imagem , Pessoa de Meia-Idade , Minnesota , Salas Cirúrgicas/economia , Recursos Humanos em Hospital/economia , Preparações Farmacêuticas/economia , Equipamentos Cirúrgicos/economia , Instrumentos Cirúrgicos/economia , Centros Cirúrgicos/economia , Lesões do Menisco Tibial , Transplante Autólogo/economia , Transplante Homólogo/economia , Ultrassonografia , Adulto JovemRESUMO
A single institution is not well positioned to manage the process of tissue donations to maximize utility and minimize the costs associated with such transactions. The proposed creation of a 'hub' organization to service the needs and demands associated with tissue procurement and utilization is outlined. The case of Arizona is used as a case study for the proposed model building on existing network in tissue donation and research. The proposed model would consequently be viewed as legitimate by various network stakeholders, including the general public. Finally, the proposed hub-network would be better able to manage the donation, procurement, storage, preservation, distribution, and use of human tissues for all of the potential uses in a single state.