Ninth International Conference on Health, Wellness & Society

Abstract

The purpose of this research is to evaluate the clinical and cost effectiveness of total knee replacement surgery (TKA) for adults hospitalized in the United States from 2008-2010. Using the National Hospital Discharge Survey (NHDS), a data bank of hospital discharges from acute care hospitals in the United States, this study seeks to identify which U.S. region renders the highest quality patient care as measured by impact on patient discharge disposition, hospital length of stay, and adverse outcomes during a three-year span of 2008-2010. Cost data, abstracted from inpatient insurance claims over a 46-month period, is utilized to evaluate cost-efficiency of the surgery in the regions of the United States. Multivariate regression analyses are used to explore the relation of hospital costs as it impacts hospital length of stay and discharges disposition throughout the United States. The results of this study indicate that in a US representative sample of hospitalized patients, the average length of stay for all regions is less than four days with the lowest lengths of stay are noted in the West and Midwest. Demographic characteristics of age, race, and marital are associated with shorter lengths of stay, however, discharge status is only significantly impacted by age. The results of this study reveal that the West has the highest patient outcomes (as measured by the length of stay and discharge disposition) and had the highest expenditure related to this surgery revealing opportunity to study these systems for patient outcome data and cost containment strategies.