Variation in the Cost of Care for Different Types of Joint Arthroplasty

• DOI: 10.2106/jbjs.19.00164
• Publication Date: 2019-11-12T10:23:50Z
• Authors: Michael P. Carducci; Gregory Gasbarro; Mariano E. Menendez; Kuhan A. Mahendraraj; David A. Mattingly; Carl Talmo; Andrew Jawa
• Keywords: Health Care Costs; Hospitals, Special; United States; 3. Good health; Hospitalization; 03 medical and health sciences; 0302 clinical medicine; Humans; Hip Prosthesis; Arthroplasty, Replacement; Procedures and Techniques Utilization; Retrospective Studies

Background: Lower-extremity arthroplasty constitutes the largest burden on health-care spending of any Medicare diagnosis group. Demand for upper extremity also continues to rise. It is necessary better understand costs as health care shifts toward a bundled-payment accounting approach. We aimed (1) identify whether variation exists in total cost different types joint arthroplasty, and, if so, (2) determine which parameters drive this variation. Methods: The episode inpatient 22,215 arthroplasties was calculated by implementing time-driven activity-based costing (TDABC) at single orthopaedic specialty hospital from 2015 2018. Implant price, supply costs, personnel and length stay knee, hip, anatomic shoulder, reverse elbow, ankle were analyzed. Individual compared with volume. Results: Higher implant appeared correlate higher represented 53.8% an cycle. Total knee least-expensive highest-volume procedure, whereas elbow had lowest volume highest (1.65 times more than that arthroplasty). Length correlated increased but did not have significant effect cost. Conclusions: our varied up factor 1.65 between fields arthroplasty. procedures—total hip arthroplasty—were least expensive, driven predominantly lower purchase prices. Clinical Relevance: are aware previous studies accurately structures across lower-extremity uniform methodology. present study, because its process, provides reliable data will allow clinicians relationships procedures.