The average total 4-year cost of RSA for the patients in this study was $24,661 (standard deviation [SD] $2527; range $19,858–$31,909), and these costs were stratified into the various subgroups based on the timing and nature of the cost. Goods and services provided by the hospital cost an average $20,451 (SD $2569; range $15,783–$27,859), whereas goods and services not provided by the hospital cost $4209 (SD $169; range $3705–$4562).

The prehospitalization, hospitalization, and posthospitalization periods accounted for 2.5, 91.6, and 5.8 % of the 4-year total cost of RSA, respectively. Within the prehospitalization period (Fig. 46.1), the shoulder CT was the most expensive component of care (34 % of prehospitalization cost). During the hospitalization period (Fig. 46.2) and also during the entire 4-year study period, the operating room was the most expensive area (86 % of hospitalization cost and 79 % of total cost). Within the operating room, the implants were the single most expensive component of care (59 % of hospitalization cost and 54 % of total cost). The surgeon’s fee was $1467 and was responsible for 6 % of total cost. In the posthospitalization period (Fig. 46.3), the home health care was the most expensive component of care (70 % of posthospitalization cost).

The cost of the six patients, which had major complications, included three patients with infection (the total cost of treatment ranged from $7192 to $34,230), two patients with postoperative fractures treated non-operatively (negligible costs), and one patient who required readmission for COPD exacerbation (hospital cost totaled $7434).