Singapore Orthopaedic Episode Cost & Budget Impact Calculator

Institutional episode-of-care modeling calibrated to Singapore MOH hospital bill structures—distinguishing patient-billed implants/biologics from internal hospital OT/CSSD consumables, facility resources, professional fees, and patient out-of-pocket.

Parameter Provenance: 🟢 SG MOH Benchmark Published MOH fee guidelines / median bill data 🟡 Literature Peer-reviewed registry / clinical probability 🔵 Hospital Input Facility-specific rate / internal overhead ⚪ Assumption User-editable scenario parameter
SG Care Setting Preset:
A. Patient-Billed Implants & Procedure Consumables Itemized Patient Charges
Hospital tender/invoice price for primary shoulder construct or suture anchor set
Patient-billed items: biologic patches (hADM/collagen), bone graft, 3D PSI jig, RF wands & shaver blades
Applied to patient-billed implants & single-use devices (MOH median implant fee: $5,517 B2 to $9,828 Private)
Total Device Acquisition: SGD $9,400 → Total Billed Implants & Biologics: SGD $12,690
B. Hospital Facility, OT & Routine Theater Consumables Internal Hospital Costs
Separates active skin-to-skin/anaesthesia minutes from room turnover minutes
Surgical Mins
Turnover Mins
Includes theater overhead, scrub/circulating nurses, and arthroscopy/power towers
Non-implant consumables: sterile drapes, gowns, gloves, gauze, irrigation & CSSD tray reprocessing
Ward bed-days × daily room, routine nursing, and inpatient medication rate
Ward Days
Rate / Day
Pre-op 3D CT/MRI workup, blood panels, intraoperative fluoroscopy, and discharge meds
C. Professional Fees (Separated per SG MOH Structure) Doctor Fees
MOH Private Surgeon Benchmark for Primary TSA: ~$12,208–$15,151 SGD (incl. GST)
Anaesthesia + interscalene nerve block + daily inpatient ward round attendance
Anaesthetist
Ward Rounds
D. Post-Discharge Recovery & Rehabilitation 90-Day Episode
Post-discharge specialist clinic reviews, serial radiographs, and structured shoulder physio
E. Expected Complication & Salvage Burden Probability × Cost
Adverse Event / Pathway 🟡 Literature Prob. (%) Event Cost ($) Expected ($)
Periprosthetic Infection / Washout
1- or 2-stage PJI management (AOANJRR / registry)		 $504
Instability / Dislocation / Readmission
Closed/open reduction or liner/glenosphere upsize		 $370
5–10 Yr Aseptic Revision Arthroplasty
Glenoid loosening / cuff failure conversion (assumption)		 $2,360
F. Payer Coverage (Patient OOP) & Annual Volume Payer & Hospital Scale
Models insurer payout % (after deductible/co-insurance) + MediSave surgical/ward claim
Insurer (%)
MediSave ($)
Annual procedures/year for hospital service-line budget & OT capacity impact

Gross Episode Bill Size (Before Insurance / MediSave)

SGD $44,440

Risk-Adjusted Total Cost (Incl. Expected Complications): SGD $47,674

Estimated Patient Out-of-Pocket (Cash Copayment)

SGD $4,388

After estimated insurer coverage (80%) and MediSave withdrawal ($4,500). Actual bills vary by Integrated Shield Plan rider & ward subsidy tier.

  • Patient-Billed Implants & Biologics (26.6%) $12,690
  • Hospital OT, Ward & CSSD/Routine (28.2%) $13,450
  • Professional Fees (Surgeon/Anaesth) (34.6%) $16,500
  • Post-Op Rehab & Follow-Up (3.8%) $1,800
  • Expected Complication Burden (6.8%) $3,234
Annualized Institutional Impact (50 Cases/Yr):
• Gross Service-Line Episode Volume: SGD $2,222,000
• Hospital Implant/Biologic Acquisition Spend: SGD $470,000
• Internal Hospital Consumables & CSSD: SGD $30,000
• Total OT Theater Time (Surg + Turnover): 129.2 Hours
• Total Inpatient Ward Bed-Days: 100.0 Bed-Days