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Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes.

Publication ,  Journal Article
Mather, RC; Nho, SJ; Federer, A; Demiralp, B; Nguyen, J; Saavoss, A; Salata, MJ; Philippon, MJ; Bedi, A; Larson, CM; Byrd, JWT; Koenig, L
Published in: Am J Sports Med
April 2018

BACKGROUND: The diagnosis and treatment of femoroacetabular impingement (FAI) have increased steadily within the past decade, and research indicates clinically significant improvements after treatment of FAI with hip arthroscopy. PURPOSE: This study examined the societal and economic impact of hip arthroscopy by high-volume surgeons for patients with FAI syndrome aged <50 years with noncontroversial diagnosis and indications for surgery. STUDY DESIGN: Economic and decision analysis; Level of evidence, 2. METHODS: The cost-effectiveness of hip arthroscopy versus nonoperative treatment was evaluated by calculating direct and indirect treatment costs. Direct cost was calculated with Current Procedural Terminology medical codes associated with FAI treatment. Indirect cost was measured with the patient-reported data of 102 patients who underwent arthroscopy and from the reimbursement records of 32,143 individuals between the ages of 16 and 79 years who had information in a private insurance claims data set contained within the PearlDiver Patient Records Database. The indirect economic benefits of hip arthroscopy were inferred through regression analysis to estimate the statistical relationship between functional status and productivity. A simulation-based approach was then used to estimate the change in productivity associated with the change in functional status observed in the treatment cohort between baseline and follow-up. To analyze cost-effectiveness, 1-, 2-, and 3-way sensitivity analyses were performed on all variables in the model, and Monte Carlo analysis evaluated the impact of uncertainty in the model assumptions. RESULTS: Analysis of indirect costs identified a statistically significant increase of mean aggregate productivity of $8968 after surgery. Cost-effectiveness analysis showed a mean cumulative total 10-year societal savings of $67,418 per patient from hip arthroscopy versus nonoperative treatment. Hip arthroscopy also conferred a gain of 2.03 quality-adjusted life years over this period. The mean cost for hip arthroscopy was estimated at $23,120 ± $10,279, and the mean cost of nonoperative treatment was estimated at $91,602 ± $14,675. In 99% of trials, hip arthroscopy was recognized as the preferred cost-effective strategy. CONCLUSION: FAI syndrome produces a substantial economic burden on society that may be reduced through the indirect cost savings and economic benefits from hip arthroscopy.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

April 2018

Volume

46

Issue

5

Start / End Page

1205 / 1213

Location

United States

Related Subject Headings

  • Young Adult
  • Quality-Adjusted Life Years
  • Quality of Life
  • Postoperative Period
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • Femoracetabular Impingement
 

Citation

APA
Chicago
ICMJE
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Mather, R. C., Nho, S. J., Federer, A., Demiralp, B., Nguyen, J., Saavoss, A., … Koenig, L. (2018). Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes. Am J Sports Med, 46(5), 1205–1213. https://doi.org/10.1177/0363546518757758
Mather, Richard C., Shane J. Nho, Andrew Federer, Berna Demiralp, Jennifer Nguyen, Asha Saavoss, Michael J. Salata, et al. “Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes.Am J Sports Med 46, no. 5 (April 2018): 1205–13. https://doi.org/10.1177/0363546518757758.
Mather RC, Nho SJ, Federer A, Demiralp B, Nguyen J, Saavoss A, et al. Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes. Am J Sports Med. 2018 Apr;46(5):1205–13.
Mather, Richard C., et al. “Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes.Am J Sports Med, vol. 46, no. 5, Apr. 2018, pp. 1205–13. Pubmed, doi:10.1177/0363546518757758.
Mather RC, Nho SJ, Federer A, Demiralp B, Nguyen J, Saavoss A, Salata MJ, Philippon MJ, Bedi A, Larson CM, Byrd JWT, Koenig L. Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes. Am J Sports Med. 2018 Apr;46(5):1205–1213.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

April 2018

Volume

46

Issue

5

Start / End Page

1205 / 1213

Location

United States

Related Subject Headings

  • Young Adult
  • Quality-Adjusted Life Years
  • Quality of Life
  • Postoperative Period
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • Femoracetabular Impingement