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THA for fracture associated with higher rates of morbidity than for OA
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DALLAS — Patients who underwent total hip arthroplasty for hip fractures showed an increased risk of postoperative morbidity compared to patients who underwent total hip arthroplasty for osteoarthritis, according to a speaker here.
“Total hip arthroplasty [THA] is a quality surgical intervention routinely performed to [treat] degenerative conditions of the hip. However, it is a fiscal burden on our health system,” David W. Fitz, MD, the recipient of the Lawrence D. Dorr Surgical Techniques & Technologies Award, said at the American Association of Hip and Knee Surgeons Annual Meeting. “Alternative payment methods have been sponsored by CMS in an attempt to transform from a passive payer quality to an active player quality.”
Fitz and his colleagues reviewed the National Surgical Quality Improvement Program data file between 2011 and 2014 to identify 58,302 patients who underwent THA for osteoarthritis (OA) and 1,580 patients who underwent THA for hip fracture. Primary outcomes of the study included CMS-reportable complications, unplanned readmission, post-surgical length of stay and discharge destination.
Results showed rates of CMS-reported complications were 4% and 10.7%, of non-home bound discharge were 39.8% and 64.7%, of readmission were 4.7% and 8%, and the mean days of post-surgical hospital stay were 3.2% and 4.4% in patients with OA and in patients with hip fractures, respectively. THA for hip fracture was significantly associated with an increased risk of CMS-reported complications, non-home bound discharge and readmission, Fitz said.
“As more and more orthopedists move toward alternative payment models, care should be formulated more accurately for any given procedure and any given diagnosis to prevent the transfer of risk to optimize the value of health care,” he said. – by Nhu Te
Reference:
Fitz D, et al. Differences in postoperative outcomes between total hip arthroplasty for fractures vs. osteoarthritis. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 10-13, 2016; Dallas.
Disclosure: Fitz reports no relevant financial disclosures.