title: Quantifying the excess cost and resource utilisation for patients with complications associated with elective knee arthroscopy: a retrospective cohort study.
abstract: BACKGROUND
  Recent studies have demonstrated morbidity associated with elective knee arthroscopy. The objective of the current study was to quantify resource utilisation and costs associated with postoperative complications following an elective knee arthroscopy.
  
  
  METHODS
  We undertook a retrospective, longitudinal cohort study using routinely collected hospital data from Victorian public hospitals during the period from 1 July 2000 to 30 June 2009. A generalised linear model was used to examine relative cost and length of stay for venous thromboembolism, joint complications and infections. Log-transformed multiple linear regression and retransformation were used to determine the excess cost after adjustment.
  
  
  RESULTS
  We identified 166,770 episodes involving an elective knee arthroscopy. There were a total of 976(0.6%) complications, including 573 patients who had a venous thromboembolism (VTE) (0.3%), 227 patients with a joint complication (0.1%) and 141 patients with infections (0.1%). After adjustment, the excess 30-day cost per patient for venous thromboembolism was $USD +3227 (95% CI: $3211-3244), for joint complications it was $USD +2247 (95% CI: $2216-2280) and for infections it was $USD +4364 (95% CI: $4331-4397).
  
  
  CONCLUSIONS
  This is the first study to quantify resource utilisation for complications associated with elective knee arthroscopy. With growing attention focused on improving patient outcomes and containing costs, understanding the nature and impact of complications on resource utilisation is important.
authors: Melbourne EpiCentre, Department of Medicine, University of Melbourne, VIC, Australia; Centre for Research Excellence in Patient Safety, Monash University, Melbourne, Australia. Electronic address: megan.bohensky@unimelb.edu.au.
authors: Megan A
authors: MA
authors: Bohensky
authors: Melbourne EpiCentre, Department of Medicine, University of Melbourne, VIC, Australia.
authors: Zanfina
authors: Z
authors: Ademi
authors: Epworth HealthCare, University of Melbourne, Australia.
authors: Richard
authors: R
authors: deSteiger
authors: Melbourne EpiCentre, Department of Medicine, University of Melbourne, VIC, Australia.
authors: Danny
authors: D
authors: Liew
authors: Department of Medicine, St. Vincent's Hospital, University of Melbourne, Australia; Department of Medicine, Southern Clinical School, Monash University, Australia.
authors: Vijaya
authors: V
authors: Sundararajan
authors: Department of Orthopaedics, Melbourne Health, Melbourne, Australia.
authors: Andrew
authors: A
authors: Bucknill
authors: Department of Orthopaedics, Melbourne Health, Melbourne, Australia.
authors: Chris
authors: C
authors: Kondogiannis
authors: Melbourne EpiCentre, Department of Medicine, University of Melbourne, VIC, Australia; Centre for Research Excellence in Patient Safety, Monash University, Melbourne, Australia.
authors: Caroline A
authors: CA
authors: Brand
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000191:economics*; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007902:Length of Stay / Q000191:economics*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000191:economics / Q000453:epidemiology; D014187:Transportation of Patients / Q000191:economics; D054556:Venous Thromboembolism / Q000191:economics / Q000453:epidemiology; D055815:Young Adult
keywords: Adverse outcomes; Arthroscopy; Cost; Epidemiology; Health services research