Value-based healthcare analysis of shoulder surgery for patients with symptomatic rotator cuff tears – Calculating the impact of arthroscopic cuff repair. (July 2022)

• Record Type: Journal Article
• Authors: Holzer-Fleming, C; Tavakkolizadeh, A; Sinha, J; Casey, J; Moxham, J; Colegate-Stone, Toby J
• Is Part Of: Shoulder & elbow. Volume 14(2022)Supplement 1
• Page Start: 59
• Page End: 70
• Publication Date: 2022-07
• Subjects: Rotator cuff repair -- value-based healthcare -- outcomes; Elbow -- Diseases -- Periodicals; Elbow -- Surgery -- Periodicals; Shoulder -- Diseases -- Periodicals; Shoulder -- Surgery -- Periodicals; Shoulder -- Periodicals; Elbow -- Periodicals; Shoulder Joint -- Periodicals; Elbow Joint -- Periodicals; 617.572005
• DOI: 10.1177/1758573220928258
• Languages: English
• ISSNs: 1758-5732

Abstract

Background: Surgical repair of full-thickness rotator cuff tears in symptomatic patients is known to offer significant benefits. Despite this there remains a lack of universal appreciation that such surgery offers high clinical value, with some commissioners even limiting access to it. The value-based healthcare agenda provides a means to design, deliver and measure the impact of healthcare to a defined segment of patients. The aim of this study was to measure the value of surgically repairing primary symptomatic full-thickness rotator cuff tears when outcomes and costs were assessed over an entire care pathway. Methods: A prospective study of patients undergoing rotator cuff tears repair was undertaken. Patients were managed using a standardised integrated care pathway. Subsequent outcomes and costs were measured over the whole care pathway. Outcomes were assessed from both traditional and patient centric re-formatted prisms. Results: Significant improvement in clinical outcomes where recognised when assessed from either the traditional or re-formatted prisms. Economic review of this approach revealed the pathway generated a sustainable and notable positive margin. Discussion: This study evidences how a well-designed value-based healthcare shoulder approach can be delivered and measured. It demonstrates rotator cuff surgery to be a high value treatment for patients with symptomatic rotator cuff tears.