Related Experiment Video
Updated: May 11, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study
Hon-Yi Shi1, Je-Ken Chang, Herng-Chia Chiu
1Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
High-volume hospitals and surgeons reduce total joint replacement costs. Analyzing and adopting their strategies can lower overall hospital charges for total hip arthroplasties (THAs).
Area of Science:
- Orthopedic Surgery
- Health Economics
- Healthcare Management
Background:
- Total hip arthroplasty (THA) is a common procedure with significant associated healthcare costs.
- Variations in hospital and surgeon volume may influence the economic outcomes of THA.
- Understanding cost drivers is crucial for optimizing healthcare resource allocation.
Purpose of the Study:
- To investigate the relationship between hospital and surgeon volume and the associated hospital charges for THA.
- To determine if high-volume providers achieve lower costs compared to low-volume providers.
- To identify potential strategies for cost reduction in THA procedures.
Main Methods:
- Retrospective cohort study analyzing 78,364 THAs performed between 1998 and 2009.
- Comparison of mean hospital charges between high-volume and low-volume hospitals and surgeons.
- Propensity score matching analysis to control for confounding factors and compare costs.
Main Results:
- The average hospital charge for THA was $4,131.9.
- High-volume hospitals and surgeons had 6% and 7% lower average charges, respectively.
- Propensity score matching revealed significantly lower charges for high-volume hospitals ($3,285.8) versus low-volume ($4,816.2) and high-volume surgeons ($3,438.5) versus low-volume ($4,404.7).
Conclusions:
- Higher hospital and surgeon volume in THA is associated with reduced hospital charges.
- Emulating treatment strategies of high-volume providers may lead to significant cost savings.
- Volume-based care models could be a strategy to decrease overall healthcare expenditures for THA.
Abstract:
This cohort study retrospectively analyzed 78,364 THAs performed from 1998 to 2009. The mean hospital charge for all THAs performed during the study period was $4,131.9 dollars. The average hospital charges for high-volume hospitals and surgeons were 6% and 7% lower, respectively, than those for low-volume hospitals and surgeons. Analysis by propensity score matching showed that hospital charges significantly differed between THA procedures performed by high- and low-volume hospitals ($3,285.8 dollars versus $4,816.2 dollars, respectively) and between THA procedures performed by high- and low-volume surgeons, ($3,438.5 dollars versus $4,404.7 dollars, respectively) (P < 0.001). The data indicate that analysis and emulation of the treatment strategies used by high-volume hospitals and by high-volume surgeons may reduce overall hospital charges.
