Percutaneous Trigger Finger Release: A Cost-effectiveness Analysis.
BACKGROUND
Percutaneous trigger finger releases (TFRs) performed in the office setting are becoming more prevalent. This study compares the costs of in-hospital open TFRs, open TFRs performed in ambulatory surgical centers (ASCs), and in-office percutaneous releases.


METHODS
An expected-value decision-analysis model was constructed from the payer perspective to estimate total costs of the three competing treatment strategies for TFR. Model parameters were estimated based on the best available literature and were tested using multiway sensitivity analysis.


RESULTS
Percutaneous TFR performed in the office and then, if needed, revised open TFR performed in the ASC, was the most cost-effective strategy, with an attributed cost of $603. The cost associated with an initial open TFR performed in the ASC was approximately 7% higher. Initial open TFR performed in the hospital was the least cost-effective, with an attributed cost nearly twice that of primary percutaneous TFR.


CONCLUSIONS
An initial attempt at percutaneous TFR is more cost-effective than an open TFR. Currently, only about 5% of TFRs are performed in the office; therefore, a substantial opportunity exists for cost savings in the future.


METHODS
Decision model level II.
From the Department of Orthopedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY.
Stephanie M
SM
Gancarczyk
Eugene S
ES
Jang
Eric P
EP
Swart
Eric C
EC
Makhni
Rajendra Kumar
RK
Kadiyala
D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D006801:Humans; D019637:Orthopedic Procedures / Q000191:economics* / Q000379:methods; D013503:Surgery Department, Hospital / Q000191:economics*; D052582:Trigger Finger Disorder / Q000191:economics / Q000601:surgery*