Study: High volume and high quality go hand in hand for hip and knee replacement

Hip and knee replacement surgery patients treated at high-volume hospitals experience fewer readmissions and complications after discharge than counterparts treated at low-volume hospitals, according to a new study published in the Journal of Bone and Joint Surgery.

For the study, researchers examined data on more than 900,000 surgeries of total hip and total knee replacements gathered in the Medicare Limited Data Set database. The team established logistic risk models for adverse outcomes like inpatient mortality, prolonged length of stay and 90-day readmissions related to the procedure.

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Hospitals with the lowest rates of complications and readmissions related to hip and knee replacements tended to perform more of these producers and had a 6 percent adverse outcome rate, while hospitals with the highest rates of complications and readmissions performed fewer procedures and displayed an adverse outcome rate of 20 percent.

"The two major events that separate top performing hospitals from suboptimal performing hospitals are inpatient complications of care and readmissions following discharge," lead author Donald E. Fry, MD, executive vice president for clinical outcomes at MPA Healthcare Solutions, said in an email release. "With the advent of a new bundled payment reimbursement system that will penalize hospitals with worse outcomes through lower reimbursement, the study findings illustrate the clear need for improvement among poor performing hospitals."

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