Cost comparison of orthopedic sports medicine procedures in an ambulatory surgical centre and a hospital outpatient department
Bibliographic record
Abstract
Background: Ambulatory surgery centres are becoming an attractive alternative to hospital-based outpatient departments; however, limited data exist on their cost efficacy in a publicly funded health care model. In this study, we aimed to compare costs for ambulatory sports medicine procedures performed at an ambulatory surgery centre and a hospital outpatient department. Methods: We retrospectively identified patients who underwent rotator cuff repair, anterior cruciate ligament reconstruction (ACLR), or hip arthroscopy between January 2020 and August 2022. We collected demographic characteristics, procedural costs, and procedural data. We used 2-sample t tests to compare care-related costs between groups treated in an ambulatory surgery centre and hospital outpatient department. Results: After controlling for age and concomitant procedures, we included a total of 132 patients for analysis. Patients who underwent hip arthroscopy or rotator cuff repair in an ambulatory surgery centre had significantly shorter duration of total operating room time, and procedural duration was equivocal (p > 0.1) between sites. Procedure time for ACLR was significantly shorter in the group treated in an ambulatory surgery centre than in the group treated in a hospital outpatient department (p = 0.01). The total case costs for the ambulatory surgery centre were significantly lower for hip arthroscopy ($3543, standard deviation (SD) $365 v. $6209, SD $681; p < 0.05), rotator cuff repair ($4259, SD $934 v. $5786, SD $934; p < 0.05), and ACLR ($3136, SD $459 v. $4821, SD $1511; p < 0.05), despite a lack of differences in associated disposable implant costs for ACLR and rotator cuff repair (p > 0.1). Material costs were significantly lower in the group receiving hip arthroscopy at an ambulatory surgery centre than in the group receiving the same procedure at a hospital outpatient department (p < 0.05). There were no differences in immediate 6-week postoperative care–associated costs between groups (p > 0.4). Conclusion: Ambulatory sports medicine procedures performed at an ambulatory surgery centre were associated with significantly reduced operating room time and total cost compared with matched cases performed via a hospital outpatient department. Ambulatory surgery centres provide an opportunity to improve cost efficacy and reduce wait-lists for surgical care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".