Utility of week one radiographs post total hip arthroplasty

et al. 2020

BMC Health Serv Res

Background Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the cost-effectiveness and safety of arthroplasty care. This study was designed to quantify the association between post-operative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty. Methods This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs. Results Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p < 0.001). Conclusions In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications.

Section: Clinical Relevancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status

et al. 2020

BMC Health Serv Res

“…Recent studies have identi ed examples of ine cient routine investigations, including radiographs and blood tests, during post-arthroplasty care in tertiary centres in USA and in China (5)(6)(7)(8)(9)(10)(11). However, only one similar study has been conducted in Australia, investigating the utility of week-one radiographs postarthroplasty (4). It is evident that further work is required to evaluate the cost-effectiveness of postoperative investigations in Australia.…”

Section: Clinical Relevancementioning

confidence: 99%

Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status

et al. 2020

Preprint

Background: Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the cost-effectiveness and safety of arthroplasty care. This study was designed to quantify the association between post-operative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty.Methods: This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs. Results: Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p<0.001).Conclusions: In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications.

“…Recent studies have identi ed examples of ine cient routine investigations, including radiographs and blood tests, during post-arthroplasty care in tertiary centres in USA and in China (5)(6)(7)(8)(9)(10)(11). In Australia, only one similar study has been conducted; it found that routine post-operative radiographs did not alter inpatient management of any patients, despite 23% having atypical radiographic ndings in that cohort (4). It is evident that further work is required to evaluate the cost-effectiveness of post-operative investigations in Australia.…”

Section: Clinical Relevancementioning

confidence: 99%

“…Post-operative investigations, which are used by clinicians to detect complications, can impose substantial burden both nancially on the health system and physically on the patient (3). Recent studies have questioned investigation practices following total hip or total knee arthroplasty, and they have identi ed existing cost-ine ciency at individual institutions (4)(5)(6)(7)(8)(9)(10)(11). However, a general lack of knowledge on current practices greatly limits the applicability of such ndings.…”

Section: Introductionmentioning

confidence: 99%

Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status

et al. 2020

Preprint

Background: Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the cost-effectiveness and safety of arthroplasty care. This study was designed to quantify the association between post-operative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty.Methods: This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs.Results: Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p<0.001).Conclusions: In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications.