Abstract
Background
A poor understanding of cost among healthcare providers may contribute to high healthcare expenditures. Currently, it is unclear whether and how much surgeons know about the costs of implantable medical devices (IMDs).
Questions/purposes
We (1) determined the level of comfort with orthopaedic IMD costs among orthopaedic residents and attending surgeons, (2) quantified how accurately surgeons understand the costs of orthopaedic IMDs, and (3) identified which constructs yield the most accurate cost estimations among residents and attending surgeons.
Methods
A questionnaire was presented to 60 residents and 37 attending orthopaedic surgeons from two large academic medical centers. Respondents estimated the cost of 13 commonly used orthopaedic devices. Fifty-one surgeons participated (36 residents, 15 attending surgeons), for an overall response rate of 53%. Cost estimates were compared against the actual material costs, and we recorded the percentage error for each estimate.
Results
More than ½ of the respondents rated their knowledge of IMD cost as poor. The mean percentage error in estimation for all respondents was 69% (range, 29%–289%). Overall, 67% of responses were underestimations and 33% were overestimations. Residents demonstrated a mean percentage error of 73% (range, 29%–289%) while attending surgeons had a mean percentage error of 59% (range, 49%–79%). Residents and attending surgeons demonstrated differences in accuracy within groups and between groups based on the IMD being estimated.
Conclusions
We found the knowledge of orthopaedic IMD costs among the orthopaedic residents and attending surgeons surveyed was poor. Further investigation of how physicians conceptualize material costs will be important to healthcare cost control.
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Acknowledgments
The authors thank the orthopaedic surgery departments at University Hospitals Case Medical Center (Cleveland, OH, USA) and the University of Michigan Medical Center (Ann Arbor, MI, USA) for their participation in this study. We also recognize the assistance of representatives from Biomet, Inc (Warsaw, IN, USA), DePuy Orthopaedics, Inc (Warsaw, IN, USA), Stryker Orthopaedics (Kalamazoo, MI, USA), Synthes, Inc (West Chester, PA, USA), and Zimmer, Inc (Warsaw, IN, USA).
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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved or waived approval for the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.
This work was performed at University Hospitals Case Medical Center (Cleveland, OH, USA) and The University of Michigan Medical Center (Ann Arbor, MI, USA).
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Streit, J.J., Youssef, A., Coale, R.M. et al. Orthopaedic Surgeons Frequently Underestimate the Cost of Orthopaedic Implants. Clin Orthop Relat Res 471, 1744–1749 (2013). https://doi.org/10.1007/s11999-012-2757-x
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DOI: https://doi.org/10.1007/s11999-012-2757-x