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ORTHOPEDICS: Trends in total joint replacement surgery

In step with the aging of the U.S. population, the number of total hip and total knee replacement procedures is increasing.  In Pennsylvania, which has had for years an independent state agency charged with collecting comparative information about the cost of care, newly published data quantify this trend.

Total Joint Replacement Procedures in Pennsylvania: 2004-2013

  • 46.1 percent increase (total hip replacement)
  • 34.9 percent increase (total knee replacement)

30-Day Readmission Rate: Pennsylvania: 2013

  • 4.3 percent (total hip replacement)
  • 3.9 percent (total knee replacement)

Volume-Outcome Relationship (there is a lot of literature on this topic…)

  • “While not applicable to an individual surgeon, in general, higher surgeon volume was associated with a patient’s decreased risk of being readmitted within 30 days after knee or hip replacement (after accounting for patient risk). Higher hospital volume was not associated with the risk of being readmitted.” (p. 11)

An interesting feature of this report is data on specific hospitals for total hip and total knee cases, 30-day readmission rate, and average charge.  There are also data on number of total hip and total knee cases for specific surgeons – and how this volume is divided among the different hospitals that each of the orthopedic surgeons operate at.  Another table compares, by hospital, the average charge and the average Medicare payment rate.

Source: Pennsylvania Health Care Cost Containment Council. (2015, June). Knee and hip replacements: 2013 data. Retrieved from http://www.phc4.org/reports/kneehip/13/docs/Knee-Hip-Replacement-Report-2015.pdf   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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