Abstract
Introduction
Our purpose is to analyze the true costs associated with preoperative CT scans performed for robotic assisted TKA planning and also to determine the value of a formal radiologist reading of these studies.
Methods
We reviewed 194 CT scans of 176 sequential patients who underwent primary RTKA by a single surgeon at a suburban teaching hospital. CT radiology reports were reviewed for the presence of incidental findings that might result in change of care to the patient. Actual payments for technical and professional components of the CT scans were retrieved for 170 of the 176 patients. Any patient payments for the CT scan were also recorded.
Results
In no CT scan report was there any findings other than arthritis in the knee and nothing was identified that lead to a recommendation for any additional testing. The mean total payment for a preoperative CT scan was $253 (range 0 – 912). The mean technical payment was $206 (range 0 – 856). The mean professional component paid was $48 (range 0 – 66). On average patients personally paid $56 (range 0 – 618). In 99/170 cases (58 %), the patients made no payment. For the remaining 71 patients the mean payment made was $134 (range 10 – 618).
Discussion and Conclusion
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No CT scan identified any clinical problem other than arthritis – this suggests that the professional component cost of this specific CT scan could be eliminated without harm to patients.
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The cost of the CT scan – mean <$300 – is low and a minimal part of the total overall cost of a primary TKA.
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Patients understand the value of the CT scan - preoperative advanced imaging helps ensure a precise and accurate intraoperative experience – and they are willing to pay for any of their costs related to this preoperative test.
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