Literature DB >> 25264442

Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study.

Michael Aynardi1, Zachary Post1, Alvin Ong1, Fabio Orozco1, Dean C Sukin1.   

Abstract

BACKGROUND: The current healthcare market coupled with expedited recovery and improvements in analgesia have led to the development of total hip arthroplasty being performed as an outpatient procedure in selected patients. QUESTIONS/PURPOSES: The purpose of this study is to compare outcomes and cost-effectiveness of traditional inpatient THA with outpatient hip replacement at the same facility. PATIENTS AND METHODS: This observational, case-control study was conducted from 2008 to 2011. One hundred nineteen patients underwent outpatient THA through a direct anterior approach. These cases were all performed by a single surgeon. Outpatient cases were then compared to inpatient hospital controls performed by the same surgeon at the inpatient hospital facility.
RESULTS: Complications, length of stay, demographic data, and overall costs were compared between groups. There was no difference in complications or estimated blood loss between groups. Most notably, the average overall cost in the outpatient setting was significantly lower than inpatient, $24,529 versus $31,327 (p = 0.0001).
CONCLUSIONS: This study demonstrates that appropriately selected patients can undergo THA in an outpatient setting with no increase in complications and at a substantial savings to the healthcare system.

Entities:  

Keywords:  Cost; Hip arthroplasty; Outcome; Outpatient

Year:  2014        PMID: 25264442      PMCID: PMC4171452          DOI: 10.1007/s11420-014-9401-0

Source DB:  PubMed          Journal:  HSS J        ISSN: 1556-3316


  11 in total

1.  Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.

Authors:  Steven Kurtz; Kevin Ong; Edmund Lau; Fionna Mowat; Michael Halpern
Journal:  J Bone Joint Surg Am       Date:  2007-04       Impact factor: 5.284

2.  Appropriateness criteria and elective procedures--total joint arthroplasty.

Authors:  Hassan M K Ghomrawi; Bruce R Schackman; Alvin I Mushlin
Journal:  N Engl J Med       Date:  2012-12-27       Impact factor: 91.245

3.  Inpatient interdisciplinary rehabilitation after total hip arthroplasty surgery: a comparison of revision and primary total hip arthroplasty.

Authors:  W C Walker; L A Keyser-Marcus; D X Cifu; M Chaudhri
Journal:  Arch Phys Med Rehabil       Date:  2001-01       Impact factor: 3.966

4.  Minimal incision protocols for anesthesia, pain management, and physical therapy with standard incisions in hip and knee arthroplasties: the effect on early outcomes.

Authors:  Douglas G Nuelle; Kathy Mann
Journal:  J Arthroplasty       Date:  2007-01       Impact factor: 4.757

5.  Minimally invasive outpatient total hip arthroplasty: a financial analysis.

Authors:  Kim C Bertin
Journal:  Clin Orthop Relat Res       Date:  2005-06       Impact factor: 4.176

6.  Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe.

Authors:  Nadia Rosencher; Hans E M Kerkkamp; G Macheras; L M Munuera; G Menichella; David M Barton; Saskia Cremers; Ivo L Abraham
Journal:  Transfusion       Date:  2003-04       Impact factor: 3.157

7.  Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty.

Authors:  Richard A Berger; Joshua J Jacobs; R Michael Meneghini; Craig Della Valle; Wayne Paprosky; Aaron G Rosenberg
Journal:  Clin Orthop Relat Res       Date:  2004-12       Impact factor: 4.176

8.  Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients.

Authors:  Henrik Husted; Gitte Holm; Steffen Jacobsen
Journal:  Acta Orthop       Date:  2008-04       Impact factor: 3.717

9.  Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients.

Authors:  Richard A Berger; Sheila A Sanders; Elizabeth S Thill; Scott M Sporer; Craig Della Valle
Journal:  Clin Orthop Relat Res       Date:  2009-02-28       Impact factor: 4.176

10.  The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study.

Authors:  Ece Unlu; Emel Eksioglu; Ece Aydog; Sedat Tolga Aydog; Gulay Atay
Journal:  Clin Rehabil       Date:  2007-08       Impact factor: 3.477

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  52 in total

1.  Definitional Differences of 'Outpatient' Versus 'Inpatient' THA and TKA Can Affect Study Outcomes.

Authors:  Patawut Bovonratwet; Matthew L Webb; Nathaniel T Ondeck; Adam M Lukasiewicz; Jonathan J Cui; Ryan P McLynn; Jonathan N Grauer
Journal:  Clin Orthop Relat Res       Date:  2017-12       Impact factor: 4.176

Review 2.  Patient selection criteria for outpatient joint arthroplasty.

Authors:  Nanne P Kort; Yoeri F L Bemelmans; P Hugo M van der Kuy; Jacqueline Jansen; Martijn G M Schotanus
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2016-04-22       Impact factor: 4.342

3.  Optimizing outpatient total hip arthroplasty: perspectives of key stakeholders.

Authors:  Laura Churchill; Michael Pollock; Yekaterina Lebedeva; Nicholas Pasic; Dianne Bryant; James Howard; Brent Lanting; Debbie Laliberte Rudman
Journal:  Can J Surg       Date:  2018-12-01       Impact factor: 2.089

4.  Successful initial experience with a novel outpatient total hip arthroplasty program in a public health system in Chile.

Authors:  Orlando Paredes; Rodrigo Ñuñez; Ianiv Klaber
Journal:  Int Orthop       Date:  2018-03-21       Impact factor: 3.075

Review 5.  Outpatient Total Joint Arthroplasty.

Authors:  Jack M Bert; Jessica Hooper; Sam Moen
Journal:  Curr Rev Musculoskelet Med       Date:  2017-12

Review 6.  Clinical and Cost Implications of Inpatient Versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature.

Authors:  Dennis C Crawford; Chuan Silvia Li; Sheila Sprague; Mohit Bhandari
Journal:  Orthop Rev (Pavia)       Date:  2015-12-30

7.  Payments for outpatient joint replacement surgery: A comparison of hospital outpatient departments and ambulatory surgery centers.

Authors:  Kathleen Carey; Jake R Morgan
Journal:  Health Serv Res       Date:  2020-01-23       Impact factor: 3.402

8.  Economic Impact of Outpatient Medicare Total Knee Arthroplasty at a Tertiary Care Academic Medical Center.

Authors:  Charles M Davis; Eric R Swenson; Travis M Lehman; Derek A Haas
Journal:  J Arthroplasty       Date:  2020-01-15       Impact factor: 4.757

9.  Patient Outcomes Following Total Joint Replacement Surgery: A Comparison of Hospitals and Ambulatory Surgery Centers.

Authors:  Kathleen Carey; Jake R Morgan; Meng-Yun Lin; Michael S Kain; William R Creevy
Journal:  J Arthroplasty       Date:  2019-08-23       Impact factor: 4.757

10.  Comparison of outpatient versus inpatient total hip and knee arthroplasty: A systematic review and meta-analysis of complications.

Authors:  Joshua Xu; Jacob Y Cao; Gurpreet S Chaggar; Jonathan J Negus
Journal:  J Orthop       Date:  2019-08-13
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