Many hospitals are not performing enough total joint replacements, study finds


A study in the Journal of Arthroplasty found many hospitals are performing total hip and knee replacements at "suboptimal volumes."  

Surgical outcomes tend to improve with volume, according to the study, published May 11. Researchers examined Medicare data from 2009 through 2015 for volume trends and used mixed-effort models to assess surgeon and hospital volumes with 30-day complications or mortality.

Complications stopped declining after volumes of cases surpassed 260 annually, the study found. 

The study found that approximately 93 percent of hip replacements and 88 percent of knee replacements were done by surgeons operating at suboptimal volumes.

Researchers concluded, "More than two decades after the volume-outcome relationship was established for joint arthroplasty, many cases continue to be performed by low-volume surgeons, with far more cases performed by surgeons operating at suboptimal volumes. Further improvement could be expected through consolidation at both the hospital and surgeon level, with a target of at least 260 cases per surgeon annually for each operation. Payers seem best equipped to drive consolidation."

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