The Journal of Arthroplasty
Volume 19, Issue 6 , Pages 700-705, September 2004

Comorbid illness affects hospital costs related to hip arthroplasty:

Quantification of health status and implications for fair reimbursement and surgeon comparisons1

  • Amit N. Shah, MD, MHSc

      Affiliations

    • School of Medicine, Durham, North Carolina, USA
    • Dr. Shah currently is a resident physician at the University of California, Los Angeles, California.
    • ,
  • Thomas P. Vail, MD

      Affiliations

    • Division of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
    • ,
  • Donald Taylor, PhD

      Affiliations

    • Center for Health Policy, Law, and Management, Duke University, Durham, North Carolina, USA
    • ,
  • Ricardo Pietrobon, MD

      Affiliations

    • Division of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
    • Corresponding Author InformationReprint requests: Ricardo Pietrobon, MD, Assistant Professor of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, PO Box 3094, Durham, NC 27710 USA

Received 31 March 2003; accepted 1 February 2004.

Abstract 

Optimized resource allocation, reimbursement negotiations, and provider comparisons hinge on an understanding of the drivers of healthcare costs. Indices of comorbid illness may be useful for stratifying patients based on cost. Total hospital cost was analyzed for 1 surgeon’s hip arthroplasty patients (June 1998-March 2001). Three scales of health status were selected as independent predictors. One thousand ninety-two hip arthroplasty inpatient stays were evaluated. The median total hospital cost was $14,011. An increasing burden of comorbid illness as measured by the All Patient Refined Diagnosis Related Group Severity of Illness scale and the modified Charlson Comorbidity Index was significantly associated with increasing hospital cost. Comorbid illness is associated with cost; scales may be used to stratify patients based on risk of high cost care.

Keywords:  cost and cost analysis, replacement hip arthroplasty, comorbidity, hospital financial management, benchmarking, health insurance reimbursement

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  • 1 No benefits or funds were received in support of this study.

PII: S0883-5403(04)00222-0

doi:10.1016/j.arth.2004.02.034

The Journal of Arthroplasty
Volume 19, Issue 6 , Pages 700-705, September 2004

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