Article
Cost Analysis of Trigger Finger Release Performed in Clinic versus in the Operating Room
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Authors
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T. J. France
- Ohio State College of Medicine, Columbus, United States
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Sonu Jain
- Ohio State College of Medicine, Columbus, United States
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: Trigger finger release (TFR) is a simple hand procedure that has routinely been performed in the operating room (OR) under sedation but is now being more frequently done as wide-awake, local anesthetic, no tourniquet (WALANT) surgery. This study seeks to compare hospital and patient costs, as well as payer reimbursement for both single and multiple TFRs performed in the office versus in the OR.
Methods: We reviewed patients having received TFR by board-certified hand surgeons from January 1, 2015 to January 1, 2018. Cost data were compiled in the form of direct and indirect costs, and stratified according to the number of TFR each patient underwent. In addition, payer information and reimbursement rates were calculated.
Results and Conclusions: There were a total of 523 patients included: 477 in the OR and 46 in the clinic. Of the OR group, 359 (75%) underwent a single TFR that incurred an average cost of $997. The total average cost of 2 and 3 simultaneous TFR in the OR group was $1200 and $1558, respectively. The cost for single and multiple TFR in the clinic group is fixed between $111 and $115. Payer reimbursement for the OR group was between $778-$2293 (78-230% of cost) for one TFR, $600-$2676 (50-223% of cost) for two simultaneous TFR, and $0-$2726 (0-175% of cost) for three simultaneous TFR. For the clinic group, payer reimbursement was between $272- $895 (240-790% of cost).
TFR in the clinic compared to the OR had an overall cost reduction of $882 for a single finger and up to $1443 for three fingers. On average, reimbursement varied greatly depending on payer type (commercial, Medicaid, Medicare, self-pay, worker's comp, and other). As a percentage of cost, payer reimbursement for clinic TFR was consistently greater than that for OR TFR independent of the number of fingers released. The higher payer reimbursement percentage in addition to lower overall cost for clinic TFR decreases the cost transferred to the patient. Overall, the office setting can provide a significant cost savings benefit to both hospital and patient, and should be considered for routine TFR procedures.
