ICJR Interviews: Economic Impact of THA for Hip Fracture

    The Diagnosis Related Group (DRG) code for total hip arthroplasty (THA) encompasses patients who are having a routine THA for osteoarthritis (OA) as well as patients who are undergoing a THA to repair a femoral neck fracture.

    By virtue of their more complex diagnosis, hip fracture patients are going to utilize more resources than OA patients, even though on the surface, both groups of patients are undergoing the same procedure.

    And that raises the question: Does reimbursement for the THA DRG adequately compensate hospitals for hip fracture patients’ care?

    To find out, Douglas E. Padgett, MD, and his colleagues at the Hospital for Special Surgery in New York used the National Surgical Quality Improvement Program database for a propensity-matched cohort study comparing the episode of care for THA patients undergoing the procedure for either OA or a femoral neck fracture.

    The study confirmed that patients who had a THA for femoral neck fracture had greater intensity of resource utilization than OA patients. Their rate of complications was higher, their length of stay was longer, and they were more likely to be discharged to continued inpatient care.

    In the changing reimbursement climate in the US – particularly in joint replacement – studies like this that show the impact of a diagnosis on resource utilization will be needed to make the case for commensurate reimbursement.

    Click the image above to hear Dr. Padgett’s comments on the study, “Total Hip Arthroplasty for Femoral Neck Fracture Versus Osteoarthritis: A Propensity-Matched Cohort Study” (Paper 704), presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer: Henrik B. Pedersen, MD; Director: Michael Bugera; Post Production: Charles J. Maynard