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EP286 Patient-Level Value Analysis of Hip Arthroscopy for Femoroacetabular Impingement
Abstract   Open access   Peer reviewed

EP286 Patient-Level Value Analysis of Hip Arthroscopy for Femoroacetabular Impingement

Steele McCulley, Rebekah Kleinsmith, Aaron Blom, Brian Cunningham and Robert Westermann
Journal of hip preservation surgery, Vol.12(Supplement_2), pp.ii118-ii119
12/01/2025
DOI: 10.1093/jhps/hnaf069.383
PMCID: PMC12720755
url
https://doi.org/10.1093/jhps/hnaf069.383View
Published (Version of record) Open Access

Abstract

Background Hip arthroscopy is becoming a very common tool to treat femoroacetabular impingement with good clinical results. As healthcare models move away from fee for service to a patient-centric value-based system, patient-level value analysis (PLVA) can be used identify procedure and patient-specific factors that can be used to predict value of care in orthopedics. Purpose The purpose of this study was to perform PLVA within the setting of primary hip arthroscopy over the 1-year episode of care. Methods A total of 264 patients underwent primary hip arthroscopy between 2020 and 2023 at one of two large metropolitan healthcare systems. The episode of care was defined as 1-year following surgery. The 12-Item International Hip Outcome Tool (iHOT-12) was used at both the initial preoperative baseline assessment and the 1-year postoperative mark. The total cost of care was determined using time-driven activity-based costing (TDABC). Both PLVA and provider-level value analysis were performed. Results A total of 264 patients were included; 82 patients with complete baseline and 1-year iHOT. There were no significant relationships between cost and age, BMI, location of procedure, or patient involvement in recreational/competitive sport. Breakdown of the contributors of cost were: implants 30.3%, procedure including OR personnel 28.2%, follow-up care 15.3%, pre-op care 3.7%, and post-op care 3.7%. Average value quotient was (Vq) = 1.0±0.6, with a total episode of care cost average of $4,510.25±$1,246.64, and an average change in iHOT of 44.3±24.2. We found no correlation between episode of care costs and 1-year improvement in iHOT (r = -0.07; p = 0.525). There was a small negative correlation between BMI and change in iHOT over the 1-year episode of care that trended towards significance (r = -0.21; p = 0.064). Conclusions We found no significant predictors of 1-year improvement in iHOT. The largest contributors of cost were implant cost, and OR cost. Drivers of cost included male sex, concomitant labral reconstruction, and inpatient stay and were all predictive of higher episode of care costs. Male patients had higher episode of care costs, largely driven by higher average implant costs.
 Capitation Costs Patients Transplants & implants Value analysis

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