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Ninety-day and one-year healthcare utilization and costs after knee arthroplasty.

Publication ,  Journal Article
Hung, A; Li, Y; Keefe, FJ; Ang, DC; Slover, J; Perera, RA; Dumenci, L; Reed, SD; Riddle, DL
Published in: Osteoarthritis Cartilage
October 2019

OBJECTIVES: This study examined ninety-day and one-year postoperative healthcare utilization and costs following total knee arthroplasty (TKA) from the health sector and patient perspectives. DESIGN: This study relied on: 1) patient-reported medical resource utilization data from diaries in the Knee Arthroplasty Pain Coping Skills Training (KASTPain) trial; and 2) Medicare fee schedules. Medicare payments, patient cost-sharing, and patient time costs were estimated. Generalized linear mixed models were used to identify baseline predictors of costs. RESULTS: In the first ninety days following TKA, patients had an average of 29.7 outpatient visits and 6% were hospitalized. Mean total costs during this period summed to $3,720, the majority attributed to outpatient visit costs (84%). Over the year following TKA, patients had an average of 48.9 outpatient visits, including 33.2 for physical therapy. About a quarter (24%) of patients were hospitalized. Medical costs were incurred at a decreasing rate, from $2,428 in the first six weeks to $648 in the last six weeks. Mean total medical costs across all patients over the year were $8,930, including $5,328 in outpatient costs. Total costs were positively associated with baseline Charlson comorbidity score (P < 0.01). Outpatient costs were positively associated with baseline Charlson comorbidity score (P = 0.03) and a bodily pain burden summary score (P < 0.01). Mean patient cost-sharing summed to $1,342 and time costs summed to $1,346. CONCLUSIONS: Costs in the ninety days and year after TKA can be substantial for both healthcare payers and patients. These costs should be considered as payers continue to explore alternative payment models.

Duke Scholars

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Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

October 2019

Volume

27

Issue

10

Start / End Page

1462 / 1469

Location

England

Related Subject Headings

  • Time Factors
  • Patient Acceptance of Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • Female
  • Arthroplasty, Replacement, Knee
  • Arthritis & Rheumatology
  • Aged
 

Citation

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Chicago
ICMJE
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Hung, A., Li, Y., Keefe, F. J., Ang, D. C., Slover, J., Perera, R. A., … Riddle, D. L. (2019). Ninety-day and one-year healthcare utilization and costs after knee arthroplasty. Osteoarthritis Cartilage, 27(10), 1462–1469. https://doi.org/10.1016/j.joca.2019.05.019
Hung, A., Y. Li, F. J. Keefe, D. C. Ang, J. Slover, R. A. Perera, L. Dumenci, S. D. Reed, and D. L. Riddle. “Ninety-day and one-year healthcare utilization and costs after knee arthroplasty.Osteoarthritis Cartilage 27, no. 10 (October 2019): 1462–69. https://doi.org/10.1016/j.joca.2019.05.019.
Hung A, Li Y, Keefe FJ, Ang DC, Slover J, Perera RA, et al. Ninety-day and one-year healthcare utilization and costs after knee arthroplasty. Osteoarthritis Cartilage. 2019 Oct;27(10):1462–9.
Hung, A., et al. “Ninety-day and one-year healthcare utilization and costs after knee arthroplasty.Osteoarthritis Cartilage, vol. 27, no. 10, Oct. 2019, pp. 1462–69. Pubmed, doi:10.1016/j.joca.2019.05.019.
Hung A, Li Y, Keefe FJ, Ang DC, Slover J, Perera RA, Dumenci L, Reed SD, Riddle DL. Ninety-day and one-year healthcare utilization and costs after knee arthroplasty. Osteoarthritis Cartilage. 2019 Oct;27(10):1462–1469.

Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

October 2019

Volume

27

Issue

10

Start / End Page

1462 / 1469

Location

England

Related Subject Headings

  • Time Factors
  • Patient Acceptance of Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • Female
  • Arthroplasty, Replacement, Knee
  • Arthritis & Rheumatology
  • Aged