Key result
Surgical team members correctly identified the more expensive arthroplasty item in 90.2% of matched pairs, but significantly overestimated the cost differences for 8 out of 10 item pairs.
Why the study?
Arthroplasty procedures significantly contribute to healthcare expenditures, but surgical team members may select implants and materials without knowing their relative cost.
Cross-Sectional (n=102)
No
While surgical team members can generally identify the more expensive arthroplasty implants, they significantly overestimate the cost differences, highlighting a lack of cost transparency that may impact value-based decision making.
May bias value-based arthroplasty choices via overestimated cost gaps; leaves open whether education improves transparency.
Arthroplasty procedures are commonly performed and contribute to healthcare expenditures seen in the United States. Surgical team members may make selections among implants and materials without always knowing their relative cost. The current study reports on a survey aimed to investigate the perceptions of an academic group about the relative cost and value of commonly used operating room implants and materials related to joint arthroplasty cases using 10 matched pairs of items. Of the 124 persons eligible to take the survey, 102 responded (response rate of 82.3%) including attendings, fellows, residents, physician assistants (PAs), advanced practice registered nurses (APRNs) and registered nurses (RNs). On average for the ten pairs of items, the more expensive items were correctly selected by 90.2+/-13.9% (mean+/- standard deviation) of respondents with a range from 54.9% to 100%. Of note, the cost differences were significantly overestimated for 8/10 item pairs. The majority of respondents perceived the more expensive item as the item with the higher clinical value for 9/10 item pairs. Most arthroplasty attendings (91.3%) indicated willingness to use the less expensive item of two similar items. Nonetheless, 17.9% of fellows, residents, PAs, APRNs and RNs indicated that they would not feel comfortable suggesting using the less expensive item. Although attending arthroplasty surgeons stated a desire to consider costs, a knowledge deficit with regards to identifying the extent of cost differences was identified, and a significant portion of the surgical support team reported being hesitant to suggest less expensive options.
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Gardezi et al. (2021) conducted a cross-sectional in Arthroplasty surgical team members (n=102). Cost awareness and value perception survey was evaluated on Correctly identifying the more expensive item among 10 matched pairs. Surgical team members correctly identified the more expensive arthroplasty item in 90.2% of matched pairs, but significantly overestimated the cost differences for 8 out of 10 item pairs.
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