The Journal of Arthroplasty
Volume 27, Issue 2 , Pages 278-285.e2, February 2012

Long-Term Trends in Hip Arthroplasty Use and Volume

  • Peter Cram, MD, MBA

      Affiliations

    • Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
    • Center for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center, Iowa City, Iowa
    • Corresponding Author InformationReprint requests: Peter Cram, MD, MBA, Division of General Medicine, University of Iowa Carver College of Medicine, Iowa City, VA Medical Center, Mail Stop 152, Iowa City, IA 52242.
    • ,
  • Xin Lu, MS

      Affiliations

    • Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
    • ,
  • John J. Callaghan, MD

      Affiliations

    • Department of Orthopaedic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
    • ,
  • Mary S. Vaughan-Sarrazin, PhD

      Affiliations

    • Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
    • Center for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center, Iowa City, Iowa
    • ,
  • Xueya Cai, PhD

      Affiliations

    • Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
    • ,
  • Yue Li, PhD

      Affiliations

    • Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa

Received 27 October 2010; accepted 30 April 2011. published online 13 July 2011.

Abstract 

We used Medicare administrative data to examine trends in primary and revision total hip arthroplasty (THA) use and hospital volume. Between 1991 and 2005, primary and revision THA use increased by 40.9% and 16.8%, respectively. The percentage of primary THA procedures performed in high-volume hospitals (those in the highest quintile of volume) increased slightly from 58.0% of all procedures in 1991 to 58.7% in 2005 (P < .01). The percentage of revisions performed in high-volume hospitals increased from 60.9% to 62.4% (P < .01). The percentage of primary THA procedures performed by low-volume hospitals remained relatively stable (P = .36), whereas the percentage of revision THA performed by low-volume hospitals declined (P < .001). In aggregate, these results suggest minimal evidence that regionalization of THA is occurring.

Keywords: total hip arthroplasty, coronary bypass graft, hospital volume

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 Supplementary material available at www.arthroplastyjournal.org.

 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.04.043.

PII: S0883-5403(11)00231-2

doi:10.1016/j.arth.2011.04.043

The Journal of Arthroplasty
Volume 27, Issue 2 , Pages 278-285.e2, February 2012

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