Evaluating Value of Trigger Finger Release: Ambulatory Surgical Center vs. Procedure Room

Introduction: As healthcare costs rise, improving cost-efficiency is essential. This study evaluates the value of trigger finger release (TFR) surgery in ambulatory surgical centers (ASCs) and procedure rooms (PRs), hypothesizing that PRs offer higher value due to lower overhead costs. Methods: The cost of TFR was assessed according to Time-Driven Activity-Based Costing (TDABC) methodology. Expenses were categorized into four categories: Direct Labor: Personnel utilization costs Direct Fixed: Building and utility fees Direct Supply: Equipment costs Indirect: Maintenance, administration, and marketing Changes in pre-operative and 3-month post-operative PROMIS Pain Interference (PI) and Upper Extremity (UE) scores were multiplied by average life-years remaining to calculate PROMIS-adjusted life-years (PALYs). Average cost-effectiveness ratios (ACERs) were calculated by dividing costs by PALYs. Differences in costs and outcomes were assessed using two-tailed t-tests. Results: Cost data was collected from 11 ASC patients and 25 PR patients. The average cost for ASC was significantly lower ($4,683.10 vs. $2,232.55, p= 0.00001122). The average PALYPI was insignificantly higher for ASC than PR (0.75 vs. 0.38, p= 0.062420651). The average PALYUE was similarly insignificantly higher for ASC than PR (0.75 vs. 0.60, p= 0.658738428). ASC ACERPI ($5,368.19/PALYPI) was lower compared to PR ACERPI ($5,976.46/PALYPI). ASC ACERUE ($5,430.19/PALYUE) was higher compared to PR ACERUE ($3,731.56/ PALYUE). Conclusion: Similar outcomes suggest cost drives TFR value, with PR as the least costly site. ACER values show PR is most valuable for UE but least for PI. Implementing cost-effective strategies, such as selecting more valuable surgical sites, is key to managing rising healthcare costs.