Inpatient total joint replacement outcomes vary widely among hospitals, study shows

Outcomes vary significantly between elective total joint replacement procedures at different hospitals, demonstrating a need for improvement among poorer performing hospitals in particular, according to a study published in The Journal of Bone & Joint Surgery.

Researchers examined the Medicare Limited Data Set database of 2010 to 2012 and identified hospitals with 50 or more qualifying cases of elective total hip replacement and total knee replacement. In all, they studied a total of 253,978 patients who underwent total hip replacement and 672,515 patients who underwent total knee replacement.

Here are three insights:

1. The observed overall adverse outcome rates were 12 percent for total hip replacement and 11.6 percent for total knee replacement.

2. For total hip replacements, the risk-adjusted adverse outcome rate for the best-performing hospitals was 6.6 percent and 19.8 percent for the poorest-performing hospitals.

3. For total knee replacements, the risk-adjusted adverse outcome rate for the best-performing hospitals was 6.4 percent and 19.3 percent for the poorest performing hospitals.

"Comparative measurement of hospital outcomes can define opportunities for care improvement and will assume great importance as alternative payment models for inpatient total joint replacement surgical procedures are introduced," the study authors wrote.

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