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AAOS: Best TKA Outcome at Very-High Volume Hospitals

Lowest lifetime costs and greatest benefits for surgery performed at very-high volume centers

knee x-ray

MONDAY, March 7, 2016 (HealthDay News) -- Undergoing total knee arthroplasty (TKA) at very-high volume hospitals is associated with the lowest lifetime costs and greatest benefits, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 1 to 5 in Orlando, Fla.

Jayme C. Burket, Ph.D., from the Hospital for Special Surgery in New York City, and colleagues compared the cost-effectiveness of primary elective unilateral TKA over a patient's lifetime among low, medium, high, and very-high volume hospitals using data from the New York Statewide Planning and Research Cooperative System from 1997 to 2014 for young (89,796 cases) and Medicare-age (111,492 cases) cohorts.

The researchers found that the lowest lifetime costs and greatest benefits were seen for TKA surgery performed at very-high volume hospitals in the young cohort (costs: $45,684; $43,222; $41,244; and $29,899, for low, medium, high, and very-high volume hospitals, respectively; corresponding benefits: 17.07, 17.15, 17.19, and 17.22, quality-adjusted life-years). Similar results were seen in the Medicare cohort, although the cost savings were more modest. Total societal cost savings would be approximately $23 million annually if patients from low, medium, and high volume hospitals in New York State regionalized to very-high volume hospitals.

"We found that knee replacement surgery at higher-volume hospitals is less costly over a patient's lifetime and provides better outcomes," Burket said in a statement.

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