Patient demand for hip and knee arthroplasty continues to rise. Information sources providing data on the volume and cost of Medicare total joint arthroplasty by hospital are of use to patients and healthcare professionals. Data have demonstrated that higher volume surgeons are associated with lower cost, morbidity, and mortality. The current study assesses if the same is true for hospitals. The Limited Data Set (LDS) from the Centers for Medicare and Medicaid (CMS) were used for this study. All elective, DRG 470 Total Hip Arthroplasties (THA) reported by CMS from the first quarter of 2013 through the second quarter of 2016 were included. Volume and part A Medicare payments over a 90-day period for the 20 highest volume hospitals in the US were analyzed. Cost associated with initial hospital stay and post discharge skilled nursing, home health, long term acute care, inpatient rehabilitation facilities, and readmission was aggregated and analyzed. For each episode, demographic information (age, sex, and race), geographic location, and Elixhauser comorbidities were calculated to control for major confounding factors in the regression.Introduction
Methods
