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 EuroQ ual 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 2.8years,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.
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 EuroQ ual 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 2.8years,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.
