An Economic Evaluation of Over 200,000 Revision Total Hip Arthroplasties: Is the Current Model Sustainable?

Autor:	DeGouveia W; Donald and Barbara Zucker School, of Medicine at Hofstra/Northwell, Hempstead, New York., Salem HS; Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York., Sodhi N; Department of Orthopedic Surgery, Long Island Jewish Medical Center, Northwell Health, New York, New York., Ani HK; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio., Vakharia R; Department of Orthopaedic Surgery, Maimonides Medical Center, New York, New York., Chen Z; Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York., Roche MW; Orthopedic Research Institute, Holy Cross Hospital, Ft. Lauderdale, Florida., Mont MA; Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York.
Jazyk:	angličtina
Zdroj:	Surgical technology international [Surg Technol Int] 2020 Nov 28; Vol. 37, pp. 367-370.
Abstrakt:	Introduction: Revision total hip arthroplasties (rTHAs) are typically more complicated than primaries and may have a greater economic burden. To date, the current economic model supporting these procedures has not been evaluated. Therefore, the purpose of this study was to determine the 10-year temporal changes in charges, reimbursement rates, and net losses in patients undergoing an rTHA utilizing a large, nationwide database. Materials and Methods: A query was performed from 2005 to 2014 to identify patients who underwent rTHA. Analyzed outcomes included trends in costs of care, reimbursement rates, and net losses per annum within the last 10 years. Charges are defined as those by the provider to the insurance company, whereas, reimbursements were those payments received from the insurance company. Net losses were calculated as the difference in charges from reimbursement rates. Results: Total charges increased from $1,119,725,881 in 2005 to $2,066,842,547 in 2014. Total reimbursements increased from $287,461,852 in 2005 to $478,430,569 in 2014. Per patient charges increased 67.4% from 2005 to 2014 and from $51,963.18 in 2005 to $86,791.07 in 2014. There was an increase in reimbursement per patient of 61.4% from $12,450.70 in 2005 to $20,090.31 in 2014. Net losses increased 68.80%, from $39,512.48 to $66,700.76 from 2005 to 2014. Conclusion: This study indicates substantial increases in charges and reimbursements over a 10-year period for patients undergoing rTHA. However, reimbursement increased at a lower rate than that of charges, resulting in major net losses. This study highlights the need to reevaluate the economic models behind rTHA for longer-term sustainment.
Databáze:	MEDLINE
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