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Average charges for a total hip arthroplasty: geographic variations, 1995
Insights
Total hip replacement (THA) is a successful surgery for hip osteoarthritis. In 1994, over 150,000 THAs and revisions were performed, with significant regional cost variations and average hospital stays of around 6 days.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Medical Device Market Analysis
Background:
- Total hip arthroplasty (THA) is a highly successful surgical intervention for severe hip osteoarthritis.
- In 1994, the United States saw approximately 124,000 primary THAs and 28,000 THA revisions.
- Significant financial and resource utilization disparities exist in THA procedures.
Purpose of the Study:
- To analyze the economic and utilization landscape of total hip arthroplasty (THA) in U.S. hospitals.
- To identify regional and state-level variations in THA costs and patient length of stay.
- To provide insights into the cost components of primary THA versus revision procedures.
Main Methods:
- Retrospective analysis of national hospital discharge data for 1994.
- Calculation of average hospital and physician charges for primary THA and THA revisions.
- Comparison of charges and lengths of stay across different U.S. geographic regions and states.
Main Results:
- Average total charges for a primary THA in 1995 were $23,260, with hospital charges comprising 72%.
- Regional cost variations were substantial, with charges ranging from $19,930 to $25,500.
- THA revision surgeries incurred higher average total charges ($27,760) and longer hospital stays (6.6 days) compared to primary THAs (5.9 days).
Conclusions:
- Total hip arthroplasty (THA) procedures exhibit considerable economic variability across U.S. regions.
- Understanding these cost and utilization patterns is crucial for healthcare management and policy.
- THA revision surgeries represent a significant cost driver compared to primary procedures.
Abstract:
The total replacement of the hip is the most successful operation for patients with debilitating osteoarthritis of the hip. An estimated 124,000 total hip arthroplasties (THAs) were performed in U.S. nonfederal short-stay hospitals in 1994 and approximately 28,000 THA revisions were also reported for that year. In 1995 the average hospital and physician charges to insurance for a THA totaled $23,260 and $27,760 for a revision of the primary THA. The average THA charges ranged from a high of $25,500 in the New England region (10 percent above the U.S. average) to $19,930 in the East South Central region (14 percent below the U.S. average). Illinois reported the highest average total charge and Michigan the lowest. The hospital THA charges averaged $16,810 and accounted for 72 percent of the total charges. Physician fees differed by 101 percent between the high reported in New York and the low in Michigan. THA patients remained hospitalized for an average of 5.9 days, ranging from 8 days in Virginia to 4.6 in Utah. Average total charges for the revision surgeries were the highest in the Middle Atlantic region ($35,660, 28.5 percent above the U.S. average) and the lowest in the East South Central region, where they were less than half, $14,930 and 46 percent lower than that for the United States as a whole. Physician fees accounted for a little more than one-fourth of the total charge and averaged $7,410. THA revision patients remained in the hospital for an average of 6.6 days.