High volume vs. low volume TJR hospitals: 5 points on cost, quality difference

A new study published in The Journal of Arthroplasty examined the impact of high-volume hospitals on total hip and knee replacements.

 

Study authors gathered CMS Inpatient Charge Data for 2,702 hospitals where 458,259 primary arthroplasty procedures were performed in 2014. They looked at data for low-volume hospitals — fewer than 100 total joint replacements per year — or high-volume hospitals. Around 47 percent of the hospitals were low volume and 12 percent were high volume. Study authors found:

1. The high-volume hospitals reported lower average hospital-specific charges, at $56, 323 compared to $60,950 for low-volume hospitals.

2. Medicare payments at high-volume hospitals were slightly lower than low-volume hospitals, at $12,131 compared to $13,289.

3. The high-volume hospitals had a 2.96 complication score, compared with 3.16 for low-volume hospitals.

4. Low-volume hospitals had lower CMS star ratings, typically 2.89 on average, when compared to high-volume hospitals, with an average star rating of 3.14.

5. The lower volume hospitals were more likely to be in the upper quartile of Medicare costs when study authors controlled for demographic and geographic factors.

"Hospitals that perform fewer than 100 TJA cases per year may benefit from adopting the practices of higher volume centers in order to improve quality and reduce costs," concluded the study authors.

More articles on orthopedics:
5 key findings on outcomes for total hip replacements in the ASC
4 key points on complication risk for outpatient total joint replacement
4 key points on appropriate patient selection for total joint replacements in ASCs

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