The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty

Christopher J. Dy*, Robert G. Marx, Hassan M K Ghomrawi, Ting Jung Pan, Geoffrey H. Westrich, Stephen Lyman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Arthroplasty
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Health care disparities
  • Health policy
  • Regionalization
  • Total hip arthroplasty
  • Total joint arthroplasty
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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