COSTS ANALYSIS OF SUCCESSFUL ROTATOR CUFF REPAIR SURGERY - AN OUTCOMESTUDY - COMPARISON OF GATEKEEPER SYSTEM IN SURGICAL PATIENTS

In an effort to determine the cost effectiveness of rotator cuff repai r surgery in workers' compensation patients, a financial analysis of 5 0 consecutive patients with a ''successful'' result was performed. Tre atment costs were analyzed from the date of initial injury through all evaluations, diagnostic studies, surgical reconstruction, physical th erapy and work hardening. Additionally, all workers' compensation paym ents and the cost of settlement was analyzed. The average cost of medi cal care was $50,302.25 per patient. The average time to return to unr estricted duty from the date of injury was II months. However, patient s referred to a specialist immediately following the diagnosis of a ro tator cuff tear had total costs that averaged $25,870.64 and returned to work an average of 7 months postoperatively. Patients managed via a ''gatekeeper'' system averaged $100,280.10 in total costs and the ave rage return to work was 18 months. These differences in cost and retur n to work were both statistically significant, P < .05. In conclusion, immediate referral of rotator cuff tears for specialized care results in decreased cost and earlier return to work.