Cost Effectiveness of Laminar Flow Systems for Total Shoulder Arthroplasty: Filtering Money from the OR
Publish place: The Archives of Bone and Joint Surgery، Vol: 8، Issue: 1
Publish Year: 1399
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_TABO-8-1_007
تاریخ نمایه سازی: 22 تیر 1399
Abstract:
Background: Laminar flow ventilation systems were developed to reduce surgical contamination in joint arthroplastyto avoid periprosthetic joint infection (PJI). The goals of this study are to evaluate the cost-effectiveness and economicviability of installing and maintaining a laminar flow system in an operating room.Methods: A Monte Carlo simulation was used to evaluate the cost effectiveness of laminar flow. The variables includedwere cost to treat PJI, incidence of PJI, cost of laminar flow, years of operating room use, and arthroplasty volume asthe dependent variable.Results: Laminar flow would be financially-justified when 1,217 (SD: 319) TSA cases are performed annually withassumed 10% reduction in PJI from laminar flow and 487 (SD: 127) with assumed 25% reduction. In a high volume OR,laminar flow costs $25.24 per case (assuming 10% reduction) and $8.24 per case (assuming 25% reduction). Laminarflow would need to reduce the incidence of PJI by 35.1% (SD: 9.1) to be a cost-effective strategy.Conclusion: This analysis demonstrates the substantial arthroplasty volume and large reduction in PJI rates required tojustify the installation and maintenance costs of this technology. This high cost of implementation should be consideredprior to installing laminar flow systems.Level of evidence: II
Keywords:
Cost effectiveness , Laminar flow , Laminar flow cost effectiveness , Laminar flow efficacy , Sensitivity analysis , Total Shoulder Arthroplasty
Authors
Daniel Davis E.
Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
Benjamin Zmistowski
Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
Joseph Abboud
Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
Surena Namdari
Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA