Percutaneous Trigger Finger Release: A Cost-effectiveness Analysis

• Published in: Journal of the American Academy of Orthopaedic Surgeons Vol. 24; no. 7; pp. 475 - 482
• Main Authors: Gancarczyk, Stephanie M., Jang, Eugene S., Swart, Eric P., Makhni, Eric C., Kadiyala, Rajendra Kumar
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-07-2016
• Subjects: Ambulatory Surgical Procedures - economics; Ambulatory Surgical Procedures - methods; Cost-Benefit Analysis; Humans; Orthopedic Procedures - economics; Orthopedic Procedures - methods; Surgery Department, Hospital - economics; Trigger Finger Disorder - economics; Trigger Finger Disorder - surgery
• ISSN: 1067-151X; 1940-5480
• DOI: 10.5435/JAAOS-D-16-00042

Introduction:
Percutaneous trigger finger releases (TFRs) performed in the office setting are becoming more prevalent. This study compares the costs of in-hospital open TFRs, open TFRs performed in ambulatory surgical centers (ASCs), and in-office percutaneous releases.
Methods:
An expected-value decision-analysis model was constructed from the payer perspective to estimate total costs of the three competing treatment strategies for TFR. Model parameters were estimated based on the best available literature and were tested using multiway sensitivity analysis.
Results:
Percutaneous TFR performed in the office and then, if needed, revised open TFR performed in the ASC, was the most cost-effective strategy, with an attributed cost of $603. The cost associated with an initial open TFR performed in the ASC was approximately 7% higher. Initial open TFR performed in the hospital was the least cost-effective, with an attributed cost nearly twice that of primary percutaneous TFR.
Discussion:
An initial attempt at percutaneous TFR is more cost-effective than an open TFR. Currently, only about 5% of TFRs are performed in the office; therefore, a substantial opportunity exists for cost savings in the future.
Level of Evidence:
Decision model level II