Ambulatory knee arthroscopic surgery yields cost savings and improved health outcomes
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Issued Date
2024-01-01
Resource Type
ISSN
09422056
eISSN
14337347
Scopus ID
2-s2.0-85189638333
Journal Title
Knee Surgery, Sports Traumatology, Arthroscopy
Rights Holder(s)
SCOPUS
Bibliographic Citation
Knee Surgery, Sports Traumatology, Arthroscopy (2024)
Suggested Citation
Luksameesate P., Watcharopas R., Sangkum L., Saengpetch N., Taychakhoonavudh S. Ambulatory knee arthroscopic surgery yields cost savings and improved health outcomes. Knee Surgery, Sports Traumatology, Arthroscopy (2024). doi:10.1002/ksa.12157 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/97983
Title
Ambulatory knee arthroscopic surgery yields cost savings and improved health outcomes
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Abstract
Purpose: This study measured the health-related quality of life (HRQoL) and costs and conducted a cost–utility analysis and budget impact analysis of ambulatory knee arthroscopic surgery compared with inpatient knee arthroscopic surgery in Thailand from a societal perspective. Methods: Health outcomes were measured in units of quality-adjusted life year (QALY) based on the Thai version of the EQ-5D-5L Health Questionnaire, and costs were obtained from an electronic database at a tertiary care hospital (Ramathibodi Hospital). A cost–utility analysis was performed to evaluate ambulatory and inpatient surgery using the societal perspective and a 2-week time horizon. The incremental cost-effectiveness ratio was applied to examine the costs and QALYs. One-way sensitivity analysis was used to investigate the robustness of the model. Budget impact analysis was performed considering over 5 years. Results: A total of 161 knee arthroscopic patients were included and divided into two groups: ambulatory surgery (58 patients) and inpatient surgery (103 patients). The total cost of the inpatient surgery was 2235 United States dollars (USD), while the ambulatory surgery cost was 2002 USD. The QALYs of inpatient surgery and ambulatory surgery were 0.79 and 0.81, respectively, resulting in the ambulatory surgery becoming a dominant strategy (cost reduction of 233 USD with an increase of 0.02 QALY) over the inpatient surgery. The ambulatory surgery led to net savings of 4.5 million USD over 5 years. Medical supply costs are one of the most influential factors affecting the change in results. Conclusion: Ambulatory knee arthroscopic surgery emerged as a cost-saving strategy over inpatient surgery, driven by lower treatment costs and enhanced HRQoL. Budget impact analysis indicated net savings over 5 years, supporting the feasibility of adopting ambulatory knee arthroscopic surgery. Our findings were advocated for its application across diverse hospitals and informed policymakers to improve reimbursement systems in low- to middle-income countries and Thailand. Level of Evidence: Level IV.