Reverse-total shoulder arthroplasty cost-effectiveness:A quality-adjusted life years comparison with total hip arthroplasty

• 作者: Daniel Bachman John Nyland Ryan Krupp
• 来源期刊: 世界骨科杂志
• 学科: 医学
• 关键词: QUALITY of LIFE ARTHROPLASTY SHOULDER Costanalysis
• 年，卷（期）: 2016,（2）
• 页码范围: 123-127
• 页数: 5页
• 分类号: R

摘要

AIM:To compare reverse-total shoulder arthroplasty(RSA)cost-effectiveness with total hip arthroplasty cost-effectiveness.METHODS:This study used a stochastic model and decision-making algorithm to compare the costeffectiveness of RSA and total hip arthroplasty.Fifteen patients underwent pre-operative,and 3,6,and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion.Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty.Quality-adjusted life year(QALY)improvements based on life expectancies were calculated.RESULTS:The cost/QALY was$3900 for total hip arthroplasty and$11100 for RSA.After adjusting the model to only include shoulder-specific physical function subscale items,the RSA QALY improved to 2.8 years,and its cost/QALY decreased to$8100.CONCLUSION:Based on industry accepted standards,cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness.Although total hip arthroplasty remains the quality of life improvement“gold standard”among arthroplasty procedures,cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.