AI Article Synopsis
- - The study analyzed 1,222 patient cases undergoing primary total hip arthroplasty (THA) to determine how specific medical conditions affect hospital costs, revealing a median total cost of $30,580 for the procedure.
- - Key findings show that higher body mass index (BMI > 35), advanced American Society of Anesthesiologists (ASA) scores, and conditions like diabetes, congestive heart failure, and peripheral vascular disease significantly increase hospital costs associated with THA.
- - The research concludes that patients with BMI > 35, peripheral vascular disease, chronic pulmonary disease, renal disease, and higher ASA scores incur greater inpatient costs during THA, mainly due to increased hospital room, board, and operating
Article Abstract
Background: Patient medical complexity increases the cost of primary total hip arthroplasty (THA). The goal of this study was to quantify the impact of specific medical comorbidities on the real hospital cost of primary THA.
Methods: This study consisted of a retrospective analysis of 1,222 patient encounters for Current Procedural Terminology code 27130 (primary THA) between January 2017 and March 2020 at a high-volume urban academic medical center. Patient demographics, comorbidities, and admission data were collected, and univariate and multivariate gamma regression analyses were performed to identify associations with increased costs incurred during THA admission.
Results: The median total cost for THA was $30,580. Univariate analysis showed increased cost for body mass index (BMI) > 35 versus BMI < 35 ($31,739 versus 30,071; P < .05), American Society of Anesthesiologists (ASA) score 3 to 4 versus ASA 1 to 2 ($32,268 versus 30,045; P < .05), prevalence of diabetes ($31,523 versus 30,379; P < .05), congestive heart failure ($34,814 versus 30,584; P < .05), peripheral vascular disease (PVD) ($35,369 versus 30,573; P < .05), chronic pulmonary disease (CPD) ($34,625 versus 30,405; P < .05), renal disease ($31,973 versus 30,352; P < .05), and increased length of stay (r = 0.424; P < .05). Multivariate gamma regression showed that BMI > 35 (relative risk [RR] = 1.05), ASA 3 to 4 (RR = 1.07), PVD (RR = 1.29), CPD (RR = 1.13), and renal disease (RR = 1.09) were independently associated with increased THA hospital cost (P < .01). Increased costs seen in BMI > 35 versus BMI < 35 patients were largely due to hospital room and board ($6,345 versus 5,766; P = .01) and operating room costs ($5,744 versus 5,185; P < .05).
Conclusions: A BMI > 35, PVD, CPD, renal disease, and ASA 3 to 4 are associated with higher inpatient hospital costs for THA.
Level Of Evidence: Level III; Retrospective cohort study.
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| http://dx.doi.org/10.1016/j.arth.2024.03.009 | DOI Listing |
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