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    ICJR Interviews: Cost Savings in TKA Linked to High-volume Hospitals

    Research has shown that complication and 30-day readmission rates are lower when total knee arthroplasty (TKA) procedures are performed at high-volume hospitals.

    What does this mean to costs and cost savings to the healthcare system?

    Plenty, according to the results of a study from the Hospital for Special Surgery in New York.

    The researchers used the New York Statewide Planning And Research Cooperative System (SPARCS) database to construct a Markov model that would predict the lifetime value of having a TKA at a high-, medium-, and low-volume hospital based on complications, readmissions, revisions, and other factors.

    Significantly, the SPARCS database includes all payers, not just Medicare, and that makes it a good representation of current patient mix in terms of age, according to Douglas E. Padgett, MD, from the Hospital for Special Surgery.

    The SPARCS data showed that complication, readmission, and revision rates were lower among patients who had elective TKAs at high-volume hospitals than among those who had the surgery at lower-volume hospitals, Dr. Padgett said.

    The resulting Markov model showed a decrease in overall lifetime costs for patients who had elective TKA at high-volume hospitals, which Dr. Padgett said support the concept of regionalizing knee replacement surgery to high-volume centers of excellence to maximize the cost-effectiveness of the procedure.

    By 2030, “regionalization of [knee replacement] patients could translate into an annual societal cost-savings of over 4.8 billion dollars,” the researchers said, assuming patient distribution at low- and medium-volume hospitals across the country is similar to what they observed in New York state.

    Click on the image above to hear Dr. Padgett’s comments on the findings and implications of the study, “The Cost-Effectiveness of Total Knee Arthroplasty at High Volume Hospitals” (Paper 895), which was presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer: Henrik B. Pedersen, MD; Director: Michael Bugera; Post Production: Charles J. Maynard