عنوان انگلیسی مقاله:
The Cost of Hip and Knee Revision Arthroplasty by Diagnosis-Related Groups: Comparing Time-Driven Activity-Based Costing and Traditional Accounting
ترجمه فارسی عنوان مقاله:
هزینه های آرتروپلاستی بازپرداخت هیپ و زانو با گروه های مرتبط با تشخیص: مقایسه هزینه های مبتنی بر فعالیت مبتنی بر زمان و حسابداری سنتی
ScienceDirect- Elsevier- The Journal of Arthroplasty, 36 (2021) 2674-2682: doi:10:1016/j:arth:2021:03:041
Christopher J. Fang MD
Background: Traditional hospital cost accounting (TA) has innate disadvantages that limit the ability to
meaningfully measure care pathways and quality improvement. Time-driven activity-based costing
(TDABC) allows a meticulous account of costs in primary total joint arthroplasty (TJA). However, differences between TA and TDABC have not been examined in revision hip and knee TJA (rTJA). We aimed
to compare total costs of rTJA by the diagnosis-related group (DRG), measured by TDABC vs TA.
Methods: Overall costs were calculated for rTJA care cycles by DRG for 2 years of financial data (2018-
2019) at our single-specialty orthopedic institution using TA and TDABC. Costs derived from TDABC,
based on time and resources used, were compared with costs derived from TA based on historical costs.
Proportions of implant and nonimplant costs were measured to total TA costs.
Results: Seven hundred ninety-three rTJAs were included in this study, with TA methodology resulting in
higher cost estimates. The total cost per DRG 468, rTJA with no comorbidities or complications (CC), DRG
467, rTJA with CC, and DRG 466, rTJA with major CC, estimated by TDABC was 69%, 67%, and 49% of the
estimation by TA, respectively. Implant and nonimplant costs represented different proportions between
Conclusion: Considerable differences exist, as TA estimations were 31%-51% higher than TDABC. The true
cost is likely a value between the estimations, but TDABC presents granular and patient-specific cost data.
TDABC for rTJA provides valuable bottom-up information on cost centers in the care pathway and, with
targeted interventions, may lead to a more optimal delivery of value-based health care
Keywords: revision total joint arthroplasty | TDABC | traditional cost accounting | economics | practice management