TY - JOUR
T1 - The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty
AU - Dy, Christopher J.
AU - Marx, Robert G.
AU - Ghomrawi, Hassan M K
AU - Pan, Ting Jung
AU - Westrich, Geoffrey H.
AU - Lyman, Stephen
N1 - Funding Information:
CJD has received funding from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) grant T32-AR07281 . SL has received funding from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) grant R03 AR05063 and Agency for Healthcare Research and Quality grant U18- HS16075 .
Publisher Copyright:
© 2014 Elsevier Inc.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, 2,560,314 patients who underwent primary total hip or knee arthroplasty from 1991 to 2006 were categorized by whether an HVH (>. 200 annual TJAs) was available locally. Associations among patient characteristics, hospital utilization, and in-hospital complications were estimated using regression modeling. The complication risk was higher (Odds Ratio 1.18 [95% CI: 1.16, 1.20]) if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks. However, patients from vulnerable groups were less likely to utilize these patterns.
AB - Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, 2,560,314 patients who underwent primary total hip or knee arthroplasty from 1991 to 2006 were categorized by whether an HVH (>. 200 annual TJAs) was available locally. Associations among patient characteristics, hospital utilization, and in-hospital complications were estimated using regression modeling. The complication risk was higher (Odds Ratio 1.18 [95% CI: 1.16, 1.20]) if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks. However, patients from vulnerable groups were less likely to utilize these patterns.
KW - Health care disparities
KW - Health policy
KW - Regionalization
KW - Total hip arthroplasty
KW - Total joint arthroplasty
KW - Total knee arthroplasty
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U2 - 10.1016/j.arth.2014.08.017
DO - 10.1016/j.arth.2014.08.017
M3 - Article
C2 - 25282073
AN - SCOPUS:84916216285
SN - 0883-5403
VL - 30
SP - 1
EP - 6
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 1
ER -
