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Resource utilization and costs before and after total joint arthroplasty.

Published on Dec 1, 2012in BMC Health Services Research1.932
· DOI :10.1186/1472-6963-12-73
Kevin J. Bozic55
Estimated H-index: 55
(UCSF: University of California, San Francisco),
Brett R. Stacey30
Estimated H-index: 30
(OHSU: Oregon Health & Science University)
+ 2 AuthorsGerry Oster51
Estimated H-index: 51
Abstract
Background The purpose of this study was to compare pre- and post-surgical healthcare costs in commercially insured total joint arthroplasty (TJA) patients with osteoarthritis (OA) in the United States (U.S.).
  • References (26)
  • Citations (43)
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References26
Newest
We reviewed our experience with total knee arthroplasties performed between 1977 and 1992 in patients who were fifty-five years old or less to determine the appropriate management for younger patients who have severe osteoarthrosis. One hundred and fourteen knee replacements were performed in eighty-eight patients who were an average of fifty-one years old (range, twenty-two to fifty-five years old). All of the operations were performed by one of the two senior ones of us (J. N. I. or W. N. S.) ...
335 CitationsSource
#1Ryan M. Nunley (Barnes-Jewish Hospital)H-Index: 21
#2Erin L. Ruh (Barnes-Jewish Hospital)H-Index: 13
Last. Robert L. Barrack (Barnes-Jewish Hospital)H-Index: 62
view all 9 authors...
Improvements in total hip arthroplasty implant design and advances in bearing materials, including modern surface arthroplasty, have resulted in these procedures being performed in younger and more active patients. There is limited information in the literature to provide to patients, employers, and insurance companies about returning to work after hip arthroplasty surgery. We conducted a multicenter telephone survey on 943 patients younger than 60 years with a University of California, Los Ange...
44 CitationsSource
#1Kevin J. Bozic (UCSF: University of California, San Francisco)H-Index: 55
#2Vanessa Chiu (UCSF: University of California, San Francisco)H-Index: 8
Last. Daniel J. Berry (Mayo Clinic)H-Index: 58
view all 7 authors...
Abstract The purpose of this study was to evaluate concordance between administrative and clinical diagnosis and procedure codes for revision total joint arthroplasty (TJA). Concordance between administrative and clinical records was determined for 764 consecutive revision TJA procedures from 4 hospitals. For revision total hip arthroplasty, concordance between clinical diagnoses and administrative claims was very good for dislocation, mechanical loosening, and periprosthetic joint infection (al...
66 CitationsSource
#1Feng Xie (St. Joseph's Healthcare Hamilton)H-Index: 28
#2Ngai-Nung Lo (SGH: Singapore General Hospital)H-Index: 19
Last. Hin-Peng Lee (NUS: National University of Singapore)H-Index: 41
view all 6 authors...
The objective of this study was to evaluate incremental cost-utility of total knee replacement (TKR) versus unicompartmental knee arthroplasty (UKA) in patients with knee osteoarthritis (OA) of the medial compartment. A 2-year non-randomised prospective observational cohort study was conducted in unicompartmental knee osteoarthritis patients scheduled for TKR (n = 431) or UKA (n = 102). Costs were identified using administrative databases and health outcomes were measured using the SF-36 and the...
22 CitationsSource
As the most common form of joint disease, osteoarthritis (OA) is associated with an extremely high economic burden. This burden is largely attributable to the effects of disability, comorbid disease, and the expense of treatment. Although typically associated with less severe effects on quality of life and per capita expenditures than rheumatoid arthritis, OA is nevertheless a more costly disease in economic terms because of its far higher prevalence. At the same time, the burden of OA is increa...
245 Citations
#1Gillian A. HawkerH-Index: 73
#2Elizabeth M. BadleyH-Index: 45
Last. James G. WrightH-Index: 64
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Background:Studies of total joint arthroplasty (TJA) have not evaluated the costs and outcomes in the context of expected arthritis worsening.Objectives:Using a cost-consequence approach, to examine changes in direct health care costs and arthritis severity after TJA for hip/knee arthritis compared
84 CitationsSource
#1Elena LosinaH-Index: 73
Last. Jeffrey N. KatzH-Index: 95
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Background Total knee arthroplasty (TKA) relieves pain and improves quality of life for persons with advanced knee osteoarthritis. However, to our knowledge, the cost-effectiveness of TKA and the influences of hospital volume and patient risk on TKA cost-effectiveness have not been investigated in the United States. Methods We developed a Markov, state-transition, computer simulation model and populated it with Medicare claims data and cost and outcomes data from national and multinational sourc...
326 CitationsSource
#1J CushnaghanH-Index: 18
#2James E. BennettH-Index: 20
Last. Curtis CooperH-Index: 174
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Objectives: To assess long-term outcome and predictors of prognosis following total knee arthroplasty (TKA) for osteoarthritis. Methods: We followed-up 325 patients from 3 English health districts approximately 6 years after TKA, along with 363 controls selected from the general population. Baseline data, collected by interview and examination, included age, sex, comorbidity, body mass index (BMI), functional status and preoperative radiographic severity of osteoarthritis. Functional status at f...
78 CitationsSource
#1Estíbaliz Loza Santamaría (Hospital Clínico San Carlos)H-Index: 25
Last. Enrique Batlle GualdaH-Index: 4
view all 6 authors...
Objective To estimate the direct and indirect osteoarthritis (OA)–attributable costs and predictors of costs of knee and hip OA in Spain. Methods This study included consecutive patients age ≥50 years with symptomatic and radiologic knee and/or hip OA who were seen at primary care centers in all provinces of Spain. Information on demographics, health status (Short Form 12 Health Survey), comorbidities (Charlson Index), clinical (Western Ontario and McMaster Universities Osteoarthritis Index [WOM...
78 CitationsSource
NIHR Health Technology Assessment Programme (Project Number 95/10/01); Howmedica Osteonics; Zimmer; DePuy, a Johnson and Johnson company; Corin Medical; Smith and Nephew Healthcare. Biomet Merck; and Wright Cremascoli
74 CitationsSource
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#1Hunter Warwick (Duke University)H-Index: 2
#2Jonathan David O'Donnell (Duke University)H-Index: 3
Last. William A. Jiranek (Duke University)H-Index: 28
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Abstract Background Recent evidence describes which interventions are driving insurance payments in the management of osteoarthritis (OA) before total knee arthroplasty (TKA); however, relatively little is known about how these costs are distributed among patients. Methods We reviewed the Humana claims database for patients who underwent primary TKA from 2009 to 2016. Insurance payments for treatment, imaging, and evaluation and management were calculated from OA diagnosis to TKA, the distributi...
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#1Mark E. RogersH-Index: 1
#2Scott DartH-Index: 1
Last. James E. FleischliH-Index: 8
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Purpose To evaluate the cost-effectiveness of treating isolated red-red zone, vertical meniscal tears with either isolated meniscal repair (IMR) or partial meniscectomy (PM) in the young adult using conservative modeling. Methods A decision-analytic Markov disease progression model with a 40-year horizon was created simulating outcomes after IMR or PM for an isolated meniscal tear. Event probabilities, costs, and utilities were used for the index procedures, and the development of osteoarthritis...
2 CitationsSource
#1Anna Cronström (Lund University)H-Index: 4
#2Håkan Nero (Lund University)H-Index: 2
Last. Leif Dahlberg (Lund University)H-Index: 39
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OBJECTIVES: To examine patient willingness and possible shift in willingness for surgery and to investigate factors associated with this shift, following participation in the digital non-surgical osteoarthritis (OA) treatment program Joint Academy.METHODS: 458 individuals (mean age 62±5.6 years, 67% women) with diagnosed hip or knee were evaluated after six weeks in Joint Academy, comprising education and exercise as well as asynchronous chat with a physical therapist. Data describing joint pain...
2 CitationsSource
#1M.B. Tariq (Cleveland Clinic Lerner College of Medicine)H-Index: 2
#2Morgan H. Jones (Cleveland Clinic)H-Index: 26
Last. Kurt P. Spindler (Cleveland Clinic)H-Index: 59
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: Patient-reported outcomes measures (PROMs) are important for the advancement of orthopaedic surgeries. The primary difficulty while collecting PROMs is obtaining adequate follow-up rates. Therefore, it is important to find methods to improve follow-up, especially in patients who have failed to respond to initial attempts. We hypothesized that PROMs follow-up could be effectively increased by sending a salvage-effort personalized surgeon letter to sports medicine patients who failed to respond ...
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#1Roshan P. Shah (CUMC: Columbia University Medical Center)H-Index: 3
#2Vasili KarasH-Index: 11
Last. Richard A. Berger (Rush University Medical Center)H-Index: 68
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Abstract Background Rapid-pathway outpatient (OTJA) and one-night inpatient (ITJA) arthroplasty require close follow-up by the surgeon. We quantify and characterize the total perioperative touches required in the first 7 days, and compare OTJA and ITJA patients. Methods We reviewed 103 consecutive primary total joint arthroplasty (TJA) patients from April 2014 without exclusion; all patients were discharged either within 5 hours or the morning after surgery. All telephone and office visits durin...
2 CitationsSource
#1William H. Harris (Harvard University)H-Index: 101
#2O.K. Muratoǧlu (Harvard University)H-Index: 41
Abstract Background Widespread adoption of crosslinked polyethylene for the acetabular articular surface for total hip arthroplasty has substantially reduced revision rates and dislocation rates. We aim to provide estimates of the resulting magnitude of the annual reduction in aggregated costs of total hip arthroplasty surgery in the United States. Methods After we obtained, from the literature, the contrasting mid-term rates of revisions and dislocations of total hip arthroplasty using conventi...
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#1M.B. Tariq (Cleveland Clinic Lerner College of Medicine)H-Index: 2
#2José F. Vega (Cleveland Clinic Lerner College of Medicine)H-Index: 1
Last. Kurt P. Spindler (Cleveland Clinic)H-Index: 59
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Abstract Background The use of patient-reported outcome measures (PROMs) has become a mainstay of orthopedic joint arthroplasty research. Large studies with >1000 participants are vital to orthopedic research, as they allow for comprehensive multivariable analysis. Achieving high follow-up rates minimizes potential response bias. Maintaining adequate follow-up rates becomes more challenging as sample size increases. We aimed to systematically review the present literature to determine the follow...
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#1Cody C. Wyles (Mayo Clinic)H-Index: 14
#2William A. Robinson (Mayo Clinic)H-Index: 79
Last. Tad M. Mabry (Mayo Clinic)H-Index: 20
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Abstract Background Bilateral total knee arthroplasty (TKA) can be performed under a single-anesthetic (SA) or staged under a two-anesthetic (TA) technique. Recently, our institution began piloting a 2-surgeon team SA method for bilateral TKA. The purpose of this study was to compare the inpatient costs and clinical outcomes in the first 90 days after surgery between the team SA, single-surgeon SA, and single-surgeon TA approaches for bilateral TKA. Methods All primary TKAs performed from 2007 t...
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#1Jonathan D. LesterH-Index: 1
#2Jacob D. Gorbaty (Carolinas Medical Center)H-Index: 2
Last. James E. FleischliH-Index: 8
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Purpose To compare the cost-effectiveness of anterior cruciate ligament (ACL) reconstruction with meniscal repair to ACL reconstruction with partial meniscectomy. Methods A decision-analytic Markov disease progression model with a 40-year horizon was created simulating outcomes after both meniscal repair and partial meniscectomy at the time of ACL reconstruction. Event probabilities, costs, and utilities were used for the index procedures. The development of osteoarthritis and subsequent knee re...
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#1Mitchell C. Weiser (Albert Einstein College of Medicine)H-Index: 2
#2Kelvin Y. Kim (NYU: New York University)H-Index: 5
Last. Roy I. Davidovitch (NYU: New York University)H-Index: 14
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Abstract Background Interest in outpatient/same-day discharge (SDD) total hip arthroplasty (THA) has been increasing over the last several years. There is considerable debate in the literature regarding the complication and readmission rates of these patients. To evaluate and validate the safety and efficacy of our institutional SDD THA care pathway, we compared the outcomes of patients undergoing SDD THA with patients who had a similar comorbidity profile and underwent inpatient THA. Methods A ...
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