Arthroscopic or open Bankart procedures: what are the costs?

The cost implications and resource utilization of arthroscopic and open Bankart procedures were evaluated to determine if differences exist between these procedures when performed in a community setting. Billing and hospital records of consecutive patients who underwent either open or arthroscopic Bankart procedures at the three facilities in our city during an 18-month period were analyzed. Procedure type (open or arthroscopic), location (hospital or surgicenter), operation time, operating room time, postanesthesia care unit time, step-down area time, charges for each of these, and anesthesiologist charges were analyzed for 11 open and 13 arthroscopic Bankart procedures. Open procedures took longer and required more operating room time than arthroscopic procedures regardless of location (P < .01). Open procedures required longer postanesthesia care unit time than arthroscopic procedures (P < .01). Facility made no difference. Anesthesia fees were less for arthroscopic ($882) than open Bankarts ($1,075) (P = .002). Total facility and anesthesia fees were less for arthroscopic ($4,747) than for open Bankarts ($6,062) (P = .05). The arthroscopic Bankart repair was performed more quickly than the open Bankart procedure, regardless of facility choice, and resulted in lower total charges. A surgicenter is less expensive whether these procedures are performed arthroscopically or open.