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Updated: Aug 8, 2025
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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Wide Geographic Variation in Resource Utilization after Shoulder Arthroplasty
Suleiman Sudah1, Mariano Menendez2, Andrew Jawa3
1Orthopedic Surgery Monmouth Medical Center.
Orthopedic Reviews
|February 27, 2023
Summary
Significant geographic variation exists in shoulder arthroplasty outcomes, impacting hospital length of stay and home discharge rates across the United States. Understanding these differences is key to optimizing patient care and resource allocation.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Healthcare Economics
Background:
- Growing interest in optimizing cost and resource utilization post-shoulder arthroplasty.
- Limited data currently guides improvement efforts in this area.
Purpose of the Study:
- To evaluate geographic variations in length of stay (LOS) and home discharge disposition after shoulder arthroplasty nationwide.
- To identify regional and state-level differences in resource utilization for shoulder replacement procedures.
Main Methods:
- Utilized Centers for Medicare and Medicaid Services data for shoulder arthroplasties (April 2019-March 2020).
- Analyzed national, regional, and state-level variation in LOS and home discharge rates.
- Assessed variation using the coefficient of variation; substantial variation defined as >0.15.
Main Results:
- Substantial state-level variation observed in home discharge rates (64%-96%) and LOS (1.01-1.86 days).
- Wide regional variation found in LOS (1.35-1.50 days) and home discharge rates (73%-85%).
- Northeast region showed longest hospital stays and lowest home discharge rates.
Conclusions:
- Significant geographic variation in healthcare resource utilization exists post-shoulder arthroplasty.
- Identified distinct regional patterns, such as the Northeast's longer stays and lower discharge rates.
- Findings support targeted strategies to reduce geographic disparities in shoulder arthroplasty outcomes.
