Study finds disparity between hospital, surgeon reimbursements for hip fracture fixation
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Despite improvements in procedural efficiency and length of stay, hospital charges and payments have increased relative to surgeon charges and payments after surgical fixation of hip fractures, according to published results.
Dennis Q. Chen, MD, and colleagues from the department of orthopaedic surgery at University of Virginia Health System analyzed a population of Medicare patients who were undergoing surgical repair of hip fractures by closed reduction and percutaneous pinning (CRPP) (n = 3,028), open reduction and internal fixation (ORIF) or intramedullary nail (IMN) (n = 25,341).
According to the study, charge multiplier (CM) and payment multiplier (PM) were calculated to determine yearly and regional ratios of hospital-to-surgeon charges over time. Additionally, researchers factored in patient demographics, mortality rates, Charlson Comorbidity Index (CCI) and length of stay (LOS).
Chen and colleagues found CM increased from 10.1 to 15.6 in CRPP procedures and from 11.9 to 17.2 in ORIF/IMN procedures, while PM increased from 15.1 to 19.2 in CRPP procedures and from 11.5 to 17.4 in ORIF/IMN procedures. Across all regions of the United States, data demonstrated continually increased hospital reimbursement relative to surgeon reimbursement despite LOS decreasing with time, the researchers wrote in the study.
“Theoretically, this decrease in LOS should decrease hospital resource utilization and consequently, hospital charges and payments,” they added. “Overall, the results confirm our hypothesis that hospital charges and payments contribute significantly more to the increasing cost of treating a hip fracture patient than surgeon charges and payments.”
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