AI Article Synopsis
- The study examines trends in total hip arthroplasty (THA) procedures, focusing on patient access and changes in surgeon availability between 2013 and 2019.
- Data from Medicare's provider utilization and payment files were analyzed to compare the number of primary THA and revision THA (revTHA) surgeons across different geographic regions.
- Results showed an increase in primary THA surgeons by 17.6%, while revTHA surgeons decreased by 36.1%, indicating a negative impact on patient access for revision procedures, likely due to economic factors.
Article Abstract
Background: While trends in the economics of revision THA (revTHA) procedures have been well-described from the standpoint of both hospitals and surgeons, their population-level effects of these trends on patient access are not well-understood.
Methods: The Medicare fee-for-service provider utilization and payment public use files were used to extract data for primary and revTHA for beneficiaries between 2013 and 2019. Primary and revTHA procedures were identified using the Healthcare Common Procedure Coding System code; 27130 for primaries and 27132, 27134, 27137, or 27138 for revisions. Geospatial analyses were performed by aggregating surgeon practice locations at the level of individual counties, hospital service areas, and hospital referral regions.
Results: The number of high-volume primary THA surgeons within the Medicare population increased by 17.6% over the study period (3,838 in 2013 to 4,515 in 2019). Conversely, the number of high-volume revTHA surgeons decreased by 36.1% (178 in 2013 to 129 in 2019). Linear regression revealed a significant increase and decrease in high-volume primary (β = 109.07, P ≤ .001) and revision (β = -13.04, P = .011) THA surgeons, respectively. Over the study period, the number of counties with at least 1 high-volume primary THA surgeon increased by 6.1% (1,194 to 1,267), while the number of counties with at least 1 high-volume revTHA surgeon decreased by 30.2% (159 to 111).
Conclusion: The present findings of declining geographic access may represent a consequence of shifting economic incentives and declining reimbursements for the care of complicated revTHA patients.
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| http://dx.doi.org/10.1016/j.arth.2023.01.006 | DOI Listing |
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