August 12, 2016
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Most patients had elective TJA surgery at higher-volume hospitals

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This study of U.S. patients who underwent elective total hip or total knee arthroplasty showed most had their surgeries performed at higher-volume hospitals. Researchers of the study also found an inverse relationship between hospital volume and complication rates.

Researchers used the National Inpatient Sample from 2000 to 2012 to quantify trends in the volume of total hip arthroplasties (THA) and total knee arthroplasties (TKA) performed. Investigators calculated county geographic and population data collected from the U.S. Census Bureau and the distance from hospitals to county centroids. Using Medicare Hospital Compare, investigators collected risk-standardized surgical complication rates and they categorized the rates for the hospitals by volume.

Findings showed a marked increase in elective primary THAs and TKAs performed during the study period. Investigators noted the number of elective primary arthroplasties performed annually increased from 343,000 arthroplasties to 851,000 arthroplasties during the study period. Overall in 2012, 65.5% of arthroplasties were performed at high-volume hospitals and 26.6% of arthroplasties were performed at very high-volume hospitals.

According to researchers, there was annual decrease in the proportion of arthroplasties performed in low-volume hospitals. This figure went from 17.9% to 5.4%. The lowest complication rates were seen in high-volume hospitals, whereas the highest complication rates were seen in low-volume hospitals. Analysis results showed the percentage of the U.S. population that lived within 50 miles of a high-volume hospital was 81.9%. by Monica Jaramillo

 

Disclosure: The researchers report no relevant financial disclosures.