Document Detail

Comparison of the hospital cost of primary and revision total knee arthroplasty after cost containment.
MedLine Citation:
PMID:  10037333     Owner:  NLM     Status:  MEDLINE    
Revision total knee arthroplasty (TKA) consumes more time, more work, and more supplies than primary TKA. This study compared the hospital cost of primary and revision TKA after the introduction of cost-containment programs (implant standardization, clinical pathway, and competitive bid implant purchasing) at our hospital. Hospital financial records of 207 primary unilateral TKA operations and 32 revision TKA operations performed from October 1993 through September 1995 were analyzed. A cost-accounting system provided actual hospital cost data for each procedure. Accurate calculation of hospital income or loss was determined for all 239 procedures. The average hospital length of stay was 4.7 days for primary unilateral TKA and 5.1 days for revision TKA. There were 26 three-component revision operations and 6 one- or two-component revision operations. The average hospital cost was $10,421 for primary TKA and $11,906 for revision TKA. The average net hospital income (hospital revenue - hospital expense) was $3211 for primary TKA and $1853 for revision TKA. The payer mix included indemnity insurance, Medicare, Medicaid, managed care, and workmen's compensation. All payers were profitable except for Medicaid and selected managed care contracts for both primary and revision TKA. As a result of cost-containment programs, revision TKA can be profitable at our institution.
R Iorio; W L Healy; J A Richards
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  22     ISSN:  0147-7447     ISO Abbreviation:  Orthopedics     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-04-16     Completed Date:  1999-04-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  195-9     Citation Subset:  IM    
Department of Orthopedic Surgery, Lahey Clinic Medical Center, Burlington, MA 01805, USA.
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MeSH Terms
Arthroplasty, Replacement, Knee / economics*,  instrumentation
Cost Control
Critical Pathways / standards*
Hospital Costs / statistics & numerical data*
Hospitals, Teaching
Income / statistics & numerical data
Insurance, Health / statistics & numerical data
Knee Prosthesis / economics*
Length of Stay / economics,  statistics & numerical data
Middle Aged
Practice Guidelines as Topic / standards*
Purchasing, Hospital / economics
Reoperation / economics
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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