title: Mortality, cost, and downstream disease of total hip arthroplasty patients in the medicare population.
abstract: The purpose of this study is to compare the differences in downstream cost and health outcomes between Medicare hip OA patients who undergo total hip arthroplasty (THA) and those who do not. All OA patients in the Medicare 5% sample (1998-2009) were separated into non-THA and THA groups. Differences in costs and risk ratios for mortality and new disease diagnoses were adjusted using logistic regression for age, sex, race, socioeconomic status, region, and Charlson score. Mortality, heart failure, depression, and diabetes were all reduced in the THA group, though there was an increased risk for atherosclerosis in the short term. The potential for selection bias was investigated with two separate propensity score analyses. This study demonstrates the potential benefit of THA in reducing mortality and improving aspects of overall health in OA patients.
authors.affiliation: Exponent, Inc., Menlo Park, California.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Lovald
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Ong
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Lau
authors.forename: Jordana K
authors.initials: JK
authors.lastname: Schmier
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.forename: Steve M
authors.initials: SM
authors.lastname: Kurtz
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data; D015897:Comorbidity; D003365:Costs and Cost Analysis; D006622:Hip Prosthesis; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data; D015207:Osteoarthritis, Hip / Q000150:complications / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D018570:Risk Assessment; D014481:United States
keywords: Medicare; downstream disease; mortality; total hip arthroplasty