The Incremental Hospital Cost and Length-of-Stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing TKA

• Published in: The Journal of arthroplasty Vol. 30; no. 1; pp. 19 - 25
• Main Authors: Culler, Steven D., PhD, Jevsevar, David S., MD, MBA, Shea, Kevin G., MD, Wright, Kimberly K., RN, Simon, April W., RN, MSN
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2015
• Subjects: adverse events; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - economics; Arthroplasty, Replacement, Knee - statistics & numerical data; Female; hospital cost; Hospital Costs - statistics & numerical data; Humans; Length of Stay - economics; Length of Stay - statistics & numerical data; length-of-stay; Male; Medicare - economics; Medicare - statistics & numerical data; Medicare beneficiaries; Middle Aged; Orthopedics; Osteoarthritis, Knee - economics; Osteoarthritis, Knee - surgery; Retrospective Studies; TKA; United States; United States; Medicare beneficiaries; hospital cost; TKA; adverse events; length-of-stay
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2014.08.023

Abstract This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing TKA. This retrospective study, using the Medicare Provider Analysis and Review file, identified 353,650 Medicare beneficiaries who underwent a primary TKA during 2011. Overall, 11.82% of Medicare beneficiaries (MBs) undergoing TKA experienced at least one of the study’s adverse events. MBs experiencing any adverse event consumed significantly more unadjusted hospital resources ($3110 cost) and had longer stays (1.3 days). The risk-adjusting incremental cost of treating adverse events ranged between $30,902 (pneumonia) and $2167 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occur infrequently; however when an adverse event occurs following TKA, it adds substantially to hospital costs.