November 21, 2017 | Today’s News

Study: Physician-owned hospitals linked to lower costs, fewer complications, and increased patient satisfaction for THA and TKA procedures

Data from a study published in the Nov. 15 issue of The Journal of Bone & Joint Surgery suggest that, compared to non-physician-owned hospitals, physician-owned hospitals may be associated with lower mean Medicare costs, fewer complications, and higher patient satisfaction following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The authors reviewed data from the U.S. Centers for Medicare & Medicaid Services on 45 physician-owned and 2,657 non-physician-owned hospitals that each performed 11 or more primary TKA and THA procedures during 2014. They found that physician-owned hospitals received lower mean Medicare payments compared to non-physician-owned hospitals for THA and TKA procedures, with no significant difference in 30-day readmission scores, and physician-owned hospitals had lower mean risk-adjusted complication scores. In addition, physician-owned hospitals outperformed non-physician-owned hospitals in all patient-satisfaction categories, including mean linear scores for recommending the hospital and overall hospital rating.

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Study: Octogenarian patients at increased risk following primary THA

A study published online in the journal Clinical Orthopaedics and Related Research examines trends associated with octogenarians who undergo THA. The researchers used Medicare administrative claims data to compare a cohort of primary THA patients aged 80 to 89 years against a cohort of primary THA patients aged 65 to 69 years. Compared to the younger cohort, they found that patients in the older cohort were more likely to have a Charlson comorbidity index score of 3 or higher, and were more likely to have coronary artery disease or congestive heart failure. In addition, the octogenarian group had a greater risk of dislocation, mortality, and risk of readmission after surgery. The researchers argue that value-based care models that penalize hospitals for readmissions and complications may inadvertently reduce access to care for octogenarian patients due to higher complication and readmission risks.

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A study conducted in China and published online in the journal Spine suggests that administration of tranexamic acid (TXA) may help reduce blood loss without affecting prethrombosis-state molecular markers for patients undergoing transforaminal thoracic interbody fusion (TTIF) surgery. Members of the research team conducted a randomized, double-blind, placebo-controlled trial of 80 patients with thoracolumbar fracture-dislocation who underwent TTIF, and who received pre- and intraoperative TXA (n = 39) or placebo (41). They found that, compared to placebo, TXA administration was linked to reduced visible and hidden blood loss and true total blood loss during surgery. In addition, the researchers found no significant difference across cohorts in prevalence of deep venous thrombosis or pulmonary embolus.

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Findings published online in the Journal of Orthopaedic Trauma suggest that implementation of a multidisciplinary working group and an antibiotic prophylaxis protocol may be associated with shorter time to administration of antibiotic prophylaxis for patients with open fractures. The authors conducted a retrospective, cohort study of 100 patients who presented with open fracture at a single, Level 1 trauma center, 50 of whom presented pre-intervention and 50 of whom presented post-intervention. They found that after implementation of an antibiotic protocol, time from admission to antibiotic administration decreased from 123.1 minutes to 35.7 minutes. In addition, time from admission to order of antibiotics decreased from 94.1 minutes to 26.1 minutes, and time from order to administration of antibiotics decreased from 29.0 minutes to 9.5 minutes.

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Research presented at the American Conference on Physician Health suggests that physician burnout may present a significant financial burden to academic medical centers and healthcare organizations. The researchers surveyed physicians and medical staff at a single institution regarding burnout, work hours, surgical specialty, anxiety, depression, and sleep-related impairment. They estimate that, if nothing were done to address burnout, 58 physicians would leave the organization within 2 years. Depending on specialty and rank of faculty, the cost of recruitment for each position would range from more than $250,000 to almost $1 million, and the projected economic loss over 2 years would range from $15.5 million to $55.5 million.

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Call for volunteers: Program Committees

Jan. 12, 2018, is the last day to submit your application for a position on a Program Committee. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:

• Adult Reconstruction Knee (one member)
• Hand & Wrist (one member)
• Practice Management/Rehabilitation (two members)
• Shoulder & Elbow (one member)

Applicants for these positions must be active or international fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)