Hospital and Surgeon Reimbursement Trends for Femoral Neck Fractures Treated With Hip Hemiarthroplasty and Total Hip Arthroplasty |
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| Affiliation: | 1. Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA;2. Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA;1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN;2. Department of Bioinformatics, Mayo Clinic, Rochester, MN;1. Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, University of Otago, Dunedin, New Zealand;2. Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Victoria, Australia;1. Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX;2. The Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT;3. University of Connecticut School of Medicine, Farmington, CT;1. Department of Anesthesiology, School of Medicine, University of California, San Diego, La Jolla, CA;2. Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA;3. Department of Anesthesiology, University of California, San Diego, La Jolla, CA;4. Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA |
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| Abstract: | BackgroundThe economic impact of hip fractures on the health care system continues to rise with continued pressure to reduce unnecessary costs while maintaining quality patient care. This study aimed to analyze the trend in hospital charges and payments relative to surgeon charges and payments in a Medicare population for hip hemiarthroplasty and total hip arthroplasty (THA) for femoral neck fracture.MethodsThe 5% Medicare sample database was used to capture hospital and surgeon charges and payments related to 32,340 patients who underwent hemiarthroplasty and 4323 patients who underwent THA for femoral neck fractures between 2005 and 2014. Two values were calculated: (1) charge multiplier (CM, ratio of hospital to surgeon charges), and (2) payment multiplier (PM, ratio of hospital to surgeon payments). Year-to-year variation and regional trends in patient demographics, Charlson Comorbidity Index (CCI), length of stay (LOS), 90-day and 1-year mortality, CM, and PM were evaluated.ResultsHospital charges were significantly higher than surgeon charges and increased substantially for hemiarthroplasty (CM of 13.6 to 19.3, P < .0001) and THA (CM of 9.8 to 14.9, P = .0006). PM followed a similar trend for both hemiarthroplasty (14.9 to 20.2; P = .001) and THA (11.9 to 17.4; P < .0001). LOS decreased significantly for hemiarthroplasty (3.78 to 3.37d; P < .0001) despite increasing CCI (6.36 to 8.39; P = .018), whereas both LOS (3.71 to 3.79 days; P = .421) and CCI (5.34 to 7.08; P = .055) remained unchanged for THA.ConclusionHospital charges and payments relative to surgeon charges and payments have increased substantially for hemiarthroplasty and THA performed for femoral neck fractures. |
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| Keywords: | total hip arthroplasty hemiarthroplasty reimbursement costs hospital charges |
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