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Speaker says to guard against hip fracture service as a profit drain

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NEWPORT BEACH, Calif. — The treatment pathway for hip fractures is variable and orthopedic departments can get a return on investment for this type of surgery by controlling implant costs and reducing other variables of the procedure, according to a presenter at the Interdisciplinary Conference on Orthopedic Value-Based Care.

“You are trying to standardize things and eliminate the variability so there is a decrease in the number of complications, a decrease in the cost [and] a decrease in the outliers,” Ranjan Gupta, MD, professor of orthopedic surgery, anatomy, neurobiology and biomedical engineering at University of California, Irvine, said. “The primary overarching thing is you have to get the surgery done within 48 hours.”

Ranjan Gupta

Patients with hip fractures must undergo multimodal optimization, which “reduces the short-term morbidity. That is where you need everyone on board,” he said, noting this can help reduce costs.

“When you are developing hip pathways, on some level, you have to be careful about choosing who is a part of your team,” Gupta said.

The number of devices used to treat hip fractures at the hospital must also be optimized and limited to improve value, he said. The trauma call panel should participate in the implant-limiting process.

“You cannot say there is one device for hip fracture,” Gupta said.

Trauma departments need a minimum of four types of devices to fix hip fractures: a hip screw, hemiarthroplasty, cephalomedullary device and cannulated screws, he noted.

“In this realm of hip fracture management, you’re still in the orthopedic realm, which needs to be optimized. That is going to require buy-in from people who have come up in the middle of the night to do the surgery, but also understanding you have to optimize the devices,” Gupta said. – by Susan M. Rapp

Reference:

Gupta R. Surgical care pathways for hip fracture. Presented at: Interdisciplinary Conference on Orthopedic Value-Based Care; Feb. 9-11, 2018; Newport Beach, California.

Disclosure: Gupta reports no relevant financial disclosures.