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Costs Outweigh Payments for Revised Hip Replacement

Posted on: 10/12/2003
When it comes to cost, a total hip replacement is one thing. But revising a failed implant is much different. No one knows better than the Hospital for Special Surgery in New York City, where this study was done on the high cost of this type of operation.

Revision surgery for a failed total hip replacement is complex and time consuming. It requires hospital space, staff, and a long hospital stay. The operation lasts longer than the original hip replacement. Bone loss is common. Often patients also need a bone graft during the procedure.

The expense of total hip revision remains high even after efforts on the part of hospitals to reduce costs. The authors of this study report the actual costs (not what was charged) for patients having a total hip replacement revision. Costs were added up in categories. Categories included operating room time, supplies, hip implant, and recovery room. Other cost categories are pharmacy, room and board, and rehab. The researchers looked for costs
above and below the average.

The authors report that costs increased with the patient's age. This is linked to the fact there are more complications in older patients. The cost was less if only part of the implant is revised or replaced. The cost was more if bone graft was used.

The authors also reported how much hospitals received from insurance companies. They found a loss for every patient over the age of 65. Patients over 65 had higher costs and lower reimbursement. And almost 60 percent of the patients in this study were older than 65.

The hospital's cost of a total hip revision is high compared to how much the hospital receives in payment. Revisions take a lot of hospital resources and often result in a loss of money for the hospital. The authors hope tracking costs and payments for operations will help hospitals get better reimbursement in the future.

John F. Crowe, MD, et al. Revision Total Hip Arthroplasty: Hospital Cost and
Reimbursement Analysis. In Clinical Orthopaedics and Related Research. August 2003. Vol. 413. Pp. 175-182.

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