title: Reverse-total shoulder arthroplasty cost-effectiveness: A quality-adjusted life years comparison with total hip arthroplasty.
abstract: OBJECTIVE
  To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness.
  
  
  METHODS
  This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated.
  
  
  RESULTS
  The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100.
  
  
  CONCLUSIONS
  Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement "gold standard" among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.
authors.affiliation: Daniel Bachman, John Nyland, Ryan Krupp, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY 40202, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bachman
authors.affiliation: Daniel Bachman, John Nyland, Ryan Krupp, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY 40202, United States.
authors.forename: John
authors.initials: J
authors.lastname: Nyland
authors.affiliation: Daniel Bachman, John Nyland, Ryan Krupp, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY 40202, United States.
authors.forename: Ryan
authors.initials: R
authors.lastname: Krupp
keywords: Arthroplasty; Cost-analysis; Quality of life; Shoulder