Outpatient Surgery as a Means of Cost Reduction in Total Hip Arthroplasty: A Case-Control Study

HSS Journal Online First Article


Michael Aynardi, MD

Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

Zachary Post, MD

Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

Alvin Ong, MD

Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

Fabio Orozco, MD

Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

Dean C. Sukin, MD

Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

Abstract

Background
The current healthcare market coupled with expedited recovery and improvements in analgesia have led to the development of total hip arthroplasty being performed as an outpatient procedure in selected patients.

Questions/Purposes
The purpose of this study is to compare outcomes and cost-effectiveness of traditional inpatient THA with outpatient hip replacement at the same facility.

Patients and Methods
This observational, case-control study was conducted from 2008 to 2011. One hundred nineteen patients underwent outpatient THA through a direct anterior approach. These cases were all performed by a single surgeon. Outpatient cases were then compared to inpatient hospital controls performed by the same surgeon at the inpatient hospital facility.

Results
Complications, length of stay, demographic data, and overall costs were compared between groups. There was no difference in complications or estimated blood loss between groups. Most notably, the average overall cost in the outpatient setting was significantly lower than inpatient, $24,529 versus $31,327 (p = 0.0001).

Conclusion
This study demonstrates that appropriately selected patients can undergo THA in an outpatient setting with no increase in complications and at a substantial savings to the healthcare system.

Level of Evidence: Therapeutic Study Level III.

This article was published online July 2014.
View the full HSS Journal Online First article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

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