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Total hip replacement: a case history

V J Keston1, A C Enthoven

  • 1Stanford University School of Business, CA, USA.

Health Care Management Review
|March 12, 1998
PubMed
Summary

Total hip replacement innovations in the U.S. have successfully lowered healthcare costs and boosted patient outcomes. This article details 14 key strategies that contributed to these improvements.

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Area of Science:

  • Orthopedic surgery
  • Health services research
  • Healthcare management

Background:

  • Total hip replacement (THR) is a common orthopedic procedure.
  • Historically, concerns existed regarding the cost-effectiveness of THR.
  • Improving quality of care while managing costs is a key healthcare challenge.

Purpose of the Study:

  • To analyze the historical trends in total hip replacement costs and quality in the U.S.
  • To identify innovations that have contributed to cost reduction and quality improvement in THR.
  • To provide a framework for implementing successful cost-saving and quality-enhancing strategies.

Main Methods:

  • Review of historical data on THR costs and quality metrics nationwide.
  • Identification and categorization of 14 distinct clinical and management innovations.
  • Analysis of the impact of these innovations on healthcare delivery and patient outcomes.

Main Results:

  • Nationwide decline in the cost of total hip replacements.
  • Concurrent improvement in the quality of total hip replacement procedures.
  • Successful implementation of diverse innovations, including patient education and competitive bidding.

Conclusions:

  • Healthcare providers can achieve both cost reduction and quality enhancement in total hip replacement.
  • A combination of clinical and management innovations is effective in optimizing THR.
  • The U.S. experience with THR offers valuable lessons for healthcare systems globally.

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