High-volume surgeons and hospital systems have been shown to deliver higher value care in several studies. However, no evidence-based volume thresholds for cost currently exist in total hip arthroplasty (THA). The objective of this study was to establish clinically meaningful volume thresholds based on cost for surgeons and hospitals performing THA. A secondary objective was to analyze the relative market share of THAs among the newly defined surgeon and hospital volume strata. Using 136,501 patients from the New York State Department of Health's SPARCS database undergoing total hip arthroplasty, we used stratum-specific likelihood ratio (SSLR) analysis of a receiver operating characteristic (ROC) curve to generate volume thresholds predictive of increased costs for both surgeons and hospitals. Additionally, we examined the relative proportion of annual THA cases performed by each of these surgeon and hospital volume strata we had established.BACKGROUND
METHODS
The purpose of this observational study was to investigate and analyze the nature of the shared content of lower extremity total joint arthroplasty (TJA) patients on Instagram. Specifically, we evaluated: 1) perspective and timing of the social media posts (pre-, peri-, or post-operative); 2) tone of the post (positive or negative); 3) focus of the post (including activities of daily living (ADLs), rehabilitation, return-to-work (RTW)); and 4) compare these findings between hip and knee arthroplasties. A search of the public Instagram domain was performed over a 6 month period. Total hip and knee arthroplasty were selected for the analysis using the following terms: “#totalhipreplacement,” “#totalkneereplacement,” and associated terms. A total of 1,287 individual public posts of human subjects were shared during the period. A categorical scoring system was manually applied for media format (photo or video), time (pre-, peri- or post-operative) period, tone (positive or negative), RTW reference, ADLs reference, rehabilitation reference, surgical site reference, radiograph image, satisfaction and dissatisfaction references. The post perspective was recorded.Objectives
Methods
