The Cost and Outcome Effectiveness of Total Hip Replacement: Technique Choice and Volume–Output Effects Matter

Applied Health Economics and Health Policy

Volumn 14, Issue 6, 2016, Pages 703-718

  Goldstein, Jonathan P ^a   Babikian, George M ^b,c   Rana, Adam J ^b,c   Mackenzie, Johanna A ^b,c   Millar, Andrew ^a  

^a BOWDOIN COLLEGE   (United States)

^b MAINE MEDICAL CENTER   (United States)

^c NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; COST EFFECTIVENESS ANALYSIS; DATA EXTRACTION; FEMALE; HIGH VOLUME HOSPITAL; HOSPITAL DISCHARGE; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; MINIMALLY INVASIVE SURGERY; MUSCLE SPARING TECHNIQUE; NURSING CARE; OUTCOME ASSESSMENT; PHYSIOTHERAPY; REGRESSION ANALYSIS; SURGICAL TECHNIQUE; TOTAL HIP PROSTHESIS; COST BENEFIT ANALYSIS; ECONOMICS; GOVERNMENT; HIP REPLACEMENT; INSURANCE; MAINE; PROCEDURES; STANDARDS; STATISTICS AND NUMERICAL DATA; TREATMENT OUTCOME; UNITED STATES;

AGED; ARTHROPLASTY, REPLACEMENT, HIP; CENTERS FOR MEDICARE AND MEDICAID SERVICES (U.S.); COST-BENEFIT ANALYSIS; FEMALE; HUMANS; INSURANCE CLAIM REVIEW; MAINE; MALE; MINIMALLY INVASIVE SURGICAL PROCEDURES; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); REGRESSION ANALYSIS; UNITED STATES;

EID: 84982862044     PISSN: 11755652     EISSN: 11791896     Source Type: Journal    
DOI: 10.1007/s40258-016-0260-3     Document Type: Article

References (68)

1. Cram P, Lu X, Kaboli PJ, Vaughan-Sarrazin MF, Cai X, Wolf BR, Li Y. Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991–2008. JAMA. 2011;305(15):1560–7.
2. Kurtz S, Ong K, Lau E, Mowat F, Halpren M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–5.
3. Pabinger C, Geissler A. Utilization rates of hip arthroplasty in OECD countries. Osteoarthr Cartil. 2014;22(6):734–41.
4. Wolford ML, Palso K, Bercovitz A (2015) Hospitalization for total hip replacement among patients aged 45 and over: United States, 2000–2010. NCHS Data Brief No. 186. National Center for Health Statistics. February.
5. Krummenauer F, Gunter KP, Witzleb WC. The incremental cost effectiveness of in-patient versus out patient rehabilitaton after total hip arthroplasty—results of a pilot investigation. Eur J Med Res. 2008;24(13):267–74.
6. United States Department of Health and Human Services. 2015. www.hhs.gov/news/press/2015pres/07/20150709.html. Accessed 14 Sept 2015.
7. Boardman DL, Lieberman JR, Thomas BJ. Impact of declining reimbursement and rising hospital costs on the feasibility of total hip arthroplasty. J Arthroplast. 1997;12(5):526–34.
8. Crowe JF, Sculco TP, Kahn B. Revision total hip arthroplasty: hospital cost and reimbursement analysis. Clin Orthop Relat Res. 2003;413:175–82.
9. Rana A, Iorio R, Healy W. Hospital economics of primary THA decreasing reimbursement and increasing cost, 1990 to 2008. Clin Orthop Relat Res. 2011;469(2):355–61.
10. Ravi B, Jenkinson R, Austin PC, Croxford R, Wasserstein D, Escott B, Paterson JM, Kreder H, Hawker GA. Relation between surgeon volume and risk of complications after total hip arthroplasty: propensity score matched cohort study. BMJ. 2014;23(348):g3284.
11. Amman S, Cizik A, Leopold S, Manner PA. Two-incision minimally invasive vs standard total hip arthroplasty: comparison of component position and hospital costs. J Arthroplast. 2012;27(8):1569–1574.e1.
12. Desser DR, Mitrick MF, Ulrich SD, Delanois RE, Mont MA. Total hip arthroplasty: comparison of two-incision and standard techniques at an AOA-accredited community hospital. JAOA. 2010;110(1):12–5.
13. Duwelius PJ, Moller HS, Burkhart RL, Waller F, Wu Y, Grunkemeier GL. The economic impact of minimally invasive total hip arthroplasty. J Arthroplast. 2011;26(6):883–5.
14. Foote J, Panchoo K, Blair P, Bannister G. Length of stay following primary total hip replacement. Orthopeaedics. 2009;91:500–4.
15. Rottger J, Scheller-Kreinsen D, Busse R. Patient-level hospital costs and length of stay after conventional versus minimally invasive total hip replacement: a propensity-matched analysis. Value Health. 2012;15(8):999–1004.
16. Schmolders J, Gravius S, Wirtz DC. Significance of minimally invasive approaches during primary hip arthroplasty—an update. Z Orthop Unfall. 2014;152(2):120–9.
17. Straumann D, Valderrabano V, Eckstein M, Dick W, Dora C. Cost-benefit analysis of MIS THA: model-based analysis of the consequences for Switzerland. Hip Int. 2006;16(2):54–7.
18. de Verteuil R, Imamura M, Zhu S, Glazener C, Fraser C, Munro N, Hutchison J, Grant A, Coyle D, Coyle K, Vale L. A systematic review of the clinical effectiveness and cost-effectiveness and economic modeling of minimal incision total hip replacement approaches in the management of arthritic disease of the hip. Health technology assessment. 2008;12(26):iii–iv, ix–223.
19. Amanatullah DF, Schraga ED. Minimally invasive total hip arthroplasty [website]. 2014 [updated 2014 Feb 25, cited 2015 Jan 10]. http://emedicine.medscape.com/article/2000333-overview. Accessed 10 Jan 2015.
20. Bal BS, Haltom D, Aleto T, Barrett M. Early complications of primary total hip replacement performed with a two-incision minimally invasive technique: surgical technique. J Bone Joint Surg Am. 2005;88(Sup 1, Pt 2):221–233.
21. Spaans AJ, van den Hout JA, Bolder SA. High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach. Acta Orthop. 2012;83(4):342–6.
22. Crawford RW, Murray DW. Total hip replacement: indications for surgery and risk factors for failure. Ann Rheum Dis. 1997;56:455–7.
23. Fehring TK, Mason JB. Catastrophic complications of minimally invasive hip surgery. A series of three cases. J Bone Joint Surg Am. 2005;87(4):711–4.
24. Greidanus NV, Chihab S, Garbuz DS, Masri B, Tanzer M, Gross A, Duncan CP. Outcomes of minimally invasive anterolateral THA are not superior to those of minimally invasive direct lateral and posterolateral THA. Clin Orthrop Relat Res. 2013;471(2):463–71.
25. Katz J, Wright J, Wright E, Osina E. Failures of total hip replacement: a population-based perspective. Orthop J. 2007;9:101–6.
26. Labek G, Thaler MF, Janda WF, Agreiter MF, Stockl B. Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg [Br]. 2011;93-B(3):293–297.
27. Mandereau C, Brzakala V, Matsoukis J. Functional recovery, complications and CT positioning of total hip replacement performed through a Rottinger anterolateral mini-incision: review of a continuous series of 103 cases. Orthop Traumatol Surg Res. 2012;98:8–16.
28. Nakata K, Nishikawa MF, Yamamoto KF, Hirota SF, Yoshikawa H. A clinical comparative study of the direct anterior with mini-posterior approach: two consecutive series. J Arthroplast. 2009;24(5):698–704.
29. Rodriguez J, Deshmukh A, Rathod P, Greiz M, Deshmane P, Hepinstall M, et al. Does the direct anterior approach in THA offer faster rehabilitation and comparable safety to the posterior approach? Clin Orthop Relat Res. 2014;472(2):455–63.
30. Jaret P. A new approach to hip surgery. The New York Times. 2013.
31. Waddell J, Johnson K, Hein W, Raabe J, Fitzgerald G, Turibio F. Orthopedic practice in total hip arthroplasty and total knee arthroplasty: results from the global orthopedic registry. Am J Orthop. 2010;39(9 Suppl):5–13.
32. Sweet RA. Anterior vs. Posterior minimally invasive surgical approaches for total hip replacement [website]. 2001 [cited 2015 Jan 10]. https://www.louortho.com/documents/THR%20-Ant%20Post%20THR%20COMPARISON%20chart%2001-09_2.pdf. Accessed 10 Jan 2015.
33. Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med. 2002;137(6):511–20.
34. Kawabuchi K, Sugihara S. The volume-outcome relationship in Japan: the case of percutaneous transluminal coronary angioplasty (PTCA) volume on mortality of acute myocardial infarction (AMI) patients. In: Wise DA, Naohiro Y, editors. Health care issues in the United States and Japan. Chicago: University of Chicago Press; 2006.
35. Kim W, Wolff S, Ho V. Measuring the volume-outcome relation for complex hospital surgery. Appl Health Econ Health Policy. 2016;. doi:10.1007/s40258-016-0241-6.
36. Luft HS, Hunt SS, Maerki SC. The volume-outcome relationship: practice-makes-perfect or selective-referral patterns? Health Serv Res. 1987;22(2):157–82.
37. Losina E, Barrett J, Mahomed NN, Baron JA, Katz JN. Early failures of total hip replacement: effect of surgeon volume. Arthritis Rheum. 2004;50(4):1338–43.
38. Gaynor M, Seider H, Vogt WB. The volume-outcome effect, scale economies, and learning-by-doing. Am Econ Rev. 2005;95(2):243–7.
39. Hentschker M, Mennicken R. The volume-outcome relationship and minimum volume standards: empirical evidence for Germany. Health Econ. 2015;24:644–58.
40. Maine Health Data Organization. All payer claims database; hip surgery data extract 2011. Augusta, Maine: Executive Branch, Maine State Government. 2014.
41. Cameron AC, Miller DL. A practitioner’s guide to cluster-robust inference. J Hum Resour. 2015;50:2.
42. Vuong QH. Likelihood ratio test for model selection and non-nested hypotheses. Econometrica. 1989;57(2):307–33.
43. Hollowell J, Grocott M, Hardy R, Haddad FS, Mythen MG, Raine R. Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay. J Eval Clin Pract. 2010;16(3):529–38.
44. Krupic F, Eisler TF, Garellick GF, Karrholm J. Influence of ethnicity and socioeconomic factors on outcome after total hip replacement. Scand J Caring Sci. 2013;27:139–46.
45. Judd D, Dennis D, Thomas A, Wolfe P, Dayton M, Stevens-Lapsley J. Muscle strength and functional recovery during the first year after THA. Clin Orthop Relat Res. 2013;472(2):654–64.
46. Schneeweiss S, Maclure M. Use of comorbidity scores for control of confounding in studies using administrative databases. Int J Epidemiol. 2000;29(5):891–8.
47. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.
48. Centers for Disease Control and Prevention. Diabetes report card 2012. Atlanta: CDC, U.S. Department of Health and Human Services; 2012.
49. Centers for Disease Control and Prevention. Fast stats—cancer. http://www.cdc.gov/NCHS/faststats/cancer.htm. Accessed 11 July 2016.
50. Blue Health Intelligence. A study of cost variation for knee and hip replacement surgeries in the U.S. Chicago: Blue Cross Blue Shield Association. 2015.
51. Greene WH. Econometric analysis. 6th ed. Upper Saddle River: Pearson; 2008.
52. Little RJA, Rubin DB. Statistical analysis with missing data. 2nd ed. Hoboken: Wiley-Interscience; 2002.
53. Carroll RJ, Ruppert D, Stefanski LA, Crainiceanu CM. Measurement error in nonlinear models: a modern perspective. 2nd ed. Boca Raton: Chapman & Hall/CRC; 2006.
54. Terza JV, Basu A, Rathouz PJ. Two stage residual inclusion estimation: addressing endogeneity in health econometric modeling. J Health Econ. 2008;27(3):531–43.
55. Baum CF, Schaffer ME, Stillman S. 2010. ivreg2: Stata module for extended instrumental variables/2SLS, GMM and AC/HAC, LIML and k-class regression. http://ideas.repec.org/c/boc/bocode/s425401.html. Accessed 15 July 2015.
56. Sanderson E, Windmeijer F. A weak instrument F-test in linear IV models with multiple endogenous variables. J Econom. 2015;. doi:10.1016/j.jeconom.2015.06.004 (in press).
57. Stock JH, Yogo M. Testing for weak instruments in linear IV regression. In: Andrews DWK, Stock JH, editors. Identification and inference for econometric models: essays in honor of Thomas Rothenberg. Cambridge: Cambridge University Press; 2005. p. 80–108.
58. Culliford D, Maskell JF, Judge A, Arden NK. A population-based survival analysis describing the association of body mass index on time to revision for total hip and knee replacements: results from the UK general practice research database. BMJ Open. 2013;3(11):1–8.
59. Jameson SS, Mason JM, Baker PN, Elson DW, Deehan DJ, Reed MR. The impact of body mass index on patient reported outcome measures (PROMs) and complications following primary hip arthroplasty. J Arthroplast. 2014;29(10):1889–18898.
60. Wallace G, Judge A, Prieto-Alhambra D, de Vries F, Arden NK, Cooper C. The effect of body mass index on the risk of post-operative complications during the 6 months following total hip replacement or total knee replacement surgery. Osteoarthr Cartil. 2014;22(7):918–27.
61. Yu XW, Ai ZS, Gao YS, Zhang CQ. Blood loss closely correlates with body mass index in total hip arthroplasty performed through direct lateral approach. Saudi Med J. 2013;34(7):709–13.
62. Stevens M, Paans NF, Wagenmakers R, van Beveren J, van Raay JJ, van der Meer K, Stewart R, Bulstra SK, Reininga IH, van den Akker-Scheek I. The influence of overweight/obesity on patient-perceived physical functioning and health-related quality of life after primary total hip arthroplasty. Obes Surg. 2012;22(4):523–9.
63. Kremers MH, Visscher SL, Kremers WK, Naessens JM, Lewallen DG. Obesity increases length of stay and direct medical costs in total hip arthroplasty. Clin Orthop Relat Res. 2014;472(4):1232–9.
64. Jackson MP, Sexton SA, Yeung E, Walter WL, Walter WK, Zicat BA. The effect of obesity on the mid-term survival and clinical outcome of cementless total hip replacement. J Bone Joint Surg Br. 2009;91(10):1296–300.
65. Michalka PK, Khan RJ, Scaddan MC, Haebich S, Chirodian N, Wimhurst JA. The influence of obesity on early outcomes in primary hip arthroplasty. J Arthroplast. 2012;27(3):391–6.
66. Batsis JA, Naessens JM, Keegan MT, Wagie AE, Huddleston PM, Huddleston JM. Impact of body mass on hospital resource use in total hip arthroplasty. Public Health Nutr. 2009;12(8):1122–32.
67. Motaghedi R, Bae JJ, Memtsoudis SG, Kim DH, Beathe JC, Paroli L, YaDeau JT, Gordon MA, Maalouf DB, Lin Y, Ma Y, Cunningham-Rundles S, Liu SS. Association of obesity with inflammation and pain after total hip arthroplasty. Clin Orthop Relat Res. 2014;472(5):1442–8.
68. Morbidity and Mortality Weekly Report. Center for Disease Control. 2004. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a2.htm. Accessed 13 Feb 2015.