Blood Management Strategies to Reduce Transfusions After Elective Lower-Extremity Joint Arthroplasty Surgeries: One Tertiary Care Hospital’s Early Experience With an Alternative Payment Model—a Total Joint “Bundle”

American Journal of Medical Quality

Volumn 32, Issue 6, 2017, Pages 668-674

  Kansagra, Ankit ^a,b   Andrzejewski, Chester ^a,b   Krushell, Robert ^a   Lehman, Andrew ^a   Greenbaum, Jordan ^a   Visintainer, Paul ^a   McGirr, Joan ^a   Mahoney, Kathleen ^a   Cloutier, Darlene ^a   Ehresman, Alice ^a   Stefan, Mihaela S ^a,b  

^a BAYSTATE MEDICAL CENTER   (United States)

^b TUFTS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

blood transfusion; health care cost; joint arthroplasty; quality improvement

Indexed keywords

ADULT; ARTHROPLASTY; ERYTHROCYTE TRANSFUSION; FEMALE; HEALTH CARE COST; HUMAN; LOWER LIMB; MAJOR CLINICAL STUDY; MALE; SURGERY; TERTIARY HEALTH CARE; TOTAL QUALITY MANAGEMENT; AGED; CARE BUNDLE; ECONOMICS; ELECTIVE SURGERY; HIP REPLACEMENT; KNEE REPLACEMENT; MIDDLE AGED; OPERATIVE BLOOD LOSS; PROCEDURES; RETROSPECTIVE STUDY; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; TERTIARY CARE CENTER;

AGED; ARTHROPLASTY, REPLACEMENT, HIP; ARTHROPLASTY, REPLACEMENT, KNEE; BLOOD LOSS, SURGICAL; ELECTIVE SURGICAL PROCEDURES; ERYTHROCYTE TRANSFUSION; FEMALE; HUMANS; LOGISTIC MODELS; MALE; MIDDLE AGED; PATIENT CARE BUNDLES; QUALITY IMPROVEMENT; RETROSPECTIVE STUDIES; TERTIARY CARE CENTERS;

EID: 85034958636     PISSN: 10628606     EISSN: 1555824X     Source Type: Journal    
DOI: 10.1177/1062860616687035     Document Type: Article

References (17)

1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780-785.
2. Nwachukwu BU, McCormick F, Provencher MT, Roche M, Rubash HE. A comprehensive analysis of Medicare trends in utilization and hospital economics for total knee and hip arthroplasty from 2005 to 2011. J Arthroplasty. 2015;30:15-18.
3. Lansky D, Nwachukwu BU, Bozic KJ. Using financial incentives to improve value in orthopaedics. Clin Orthop Relat Res. 2012;470:1027-1037.
4. Centers for Medicare & Medicaid Services. Comprehensive Care for Joint Replacement Model. https://innovation.cms.gov/initiatives/cjr. Accessed May 12, 2016.
5. Browne JA, Adib F, Brown TE, Novicoff WM. Transfusion rates are increasing following total hip arthroplasty: risk factors and outcomes. J Arthroplasty. 2013;28(8, suppl):34-37.
6. Carson JL, Terrin ML, Noveck H. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365:2453-2462.
7. Carson JL, Grossman BJ, Kleinman S. Red blood cell transfusion: a clinical practice guideline from the AABB*. Ann Intern Med. 2012;157:49-58.
8. Bou Monsef J, Boettner F. Blood management may have an impact on length of stay after total hip arthroplasty. HSS J. 2014;10:124-130.
9. He P, Zhang Z, Li Y, Xu D, Wang H. Efficacy and safety of tranexamic acid in bilateral total knee replacement: a meta-analysis and systematic review. Med Sci Monit. 2015;21:3634-3642.
10. Whitcomb WF, Lagu T, Krushell RJ. Experience with designing and implementing a bundled payment program for total hip replacement. Jt Comm J Qual Patient Saf. 2015;41:406-413.
11. Shander A, Hofmann A, Ozawa S, Theusinger OM, Gombotz H, Spahn DR. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion. 2010;50:753-765.
12. Whitaker BI. The 2011 National Blood Collection and Utilization Survery Report. http://www.aabb.org/research/hemovigilance/bloodsurvey/Documents/11-nbcus-report.pdf. Accessed July 27, 2015.
13. Papke LE, Wooldridge JM. Econometric methods for fractional response variables with an application to 401(k) plan participation rates. J Appl Econom. 1996;11:619-632.
14. AABB. Building a better patient blood management program. http://www.aabb.org/pbm/Documents/AABB-PBM-Whitepaper.pdf. Accessed July 27, 2015.
15. Kansagra AJ, Stefan MS. Preoperative anemia: evaluation and treatment. Anesthesiol Clin. 2016;34:127-141.
16. Huang F, Wu Y, Yin Z, Ma G, Chang J. A systematic review and meta-analysis of the use of antifibrinolytic agents in total hip arthroplasty. Hip Int. 2015;25:502-509.
17. Rasouli MR, Maltenfort MG, Erkocak OF, Austin MS, Waters JH, Parvizi J. Blood management after total joint arthroplasty in the United States: 19-year trend analysis. Transfusion. 2016;56:1112-1120.