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Orthopedic procedures in U.S. hospitals rose almost 25% between 1997 and 2005

Medicare paid for nearly 60% of all hip and knee arthroplasties, while private insurers paid for more than half of all spinal fusions.

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The number of orthopedic procedures performed in U.S. hospitals, including total knee arthroplasty, partial or total hip arthroplasty and spinal fusion, increased by almost 25% — from 822,000 to 1.3 million — between 1997 and 2005, according to the Agency for Healthcare Research and Quality, part of the the U.S. Department of Health and Human Services.

Chaya Merrill, MPH, and Anne Elixhauser, PhD, reviewed data collected as part of the Healthcare Cost and Utilization Project (HCUP), focusing on hospital stays involving musculoskeletal procedures performed between 1997 and 2005.

The researchers found that the number of knee arthroplasties increased 69%, from 328,800 procedures in 1997 to 555,800 in 2005. Hip arthroplasties increased 32%, from 290,700 procedures in 1997 to 383,500 procedures in 2005.

The number of spinal fusions performed increased most — 73% — from 202,100 procedures in 1997 to 349,400 in 2005, according to a press release from the Agency for Healthcare Research and Quality (AHRQ).

The researchers also found that women were 60% more likely than men to receive a hip replacement and 70% more likely to undergo knee replacement. However, men and women had a similar likelihood for undergoing spinal fusion.

Overall, costs for hospitalization related to orthopedic procedures totaled $31.5 billion in 2004, or 10.7% of the total costs for all hospitalizations, according to the study.

Also for 2004, Medicare paid the largest share of hospital costs related to knee and hip arthroplasties, reimbursing for 57.9% of all knee arthroplasties and for 63.4% of all hip arthroplasties.

However, private insurers paid for 52.2% of all spinal fusion procedures, according to the study.

The researchers based the report on data from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-federal hospitals, which comprise 90% of all discharges in the United States.

For more information:

• Merrill C, Elixhauser A. Hospital stays involving musculoskeletal procedures, 1997—2005. HCUP Statistical Brief #34. July 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb34.pdf.