title: Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study.
abstract: BACKGROUND
  The current healthcare market coupled with expedited recovery and improvements in analgesia have led to the development of total hip arthroplasty being performed as an outpatient procedure in selected patients.
  
  
  OBJECTIVE
  The purpose of this study is to compare outcomes and cost-effectiveness of traditional inpatient THA with outpatient hip replacement at the same facility.
  
  
  METHODS
  This observational, case-control study was conducted from 2008 to 2011. One hundred nineteen patients underwent outpatient THA through a direct anterior approach. These cases were all performed by a single surgeon. Outpatient cases were then compared to inpatient hospital controls performed by the same surgeon at the inpatient hospital facility.
  
  
  RESULTS
  Complications, length of stay, demographic data, and overall costs were compared between groups. There was no difference in complications or estimated blood loss between groups. Most notably, the average overall cost in the outpatient setting was significantly lower than inpatient, $24,529 versus $31,327 (p = 0.0001).
  
  
  CONCLUSIONS
  This study demonstrates that appropriately selected patients can undergo THA in an outpatient setting with no increase in complications and at a substantial savings to the healthcare system.
authors.affiliation: Orthopaedic Surgery, Thomas Jefferson University, 1025 Walnut Street, Room 516 College Building, Philadelphia, PA 19107 USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Aynardi
authors.affiliation: Orthopaedic Surgery, Thomas Jefferson University, 1025 Walnut Street, Room 516 College Building, Philadelphia, PA 19107 USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Post
authors.affiliation: Orthopaedic Surgery, Thomas Jefferson University, 1025 Walnut Street, Room 516 College Building, Philadelphia, PA 19107 USA.
authors.forename: Alvin
authors.initials: A
authors.lastname: Ong
authors.affiliation: Orthopaedic Surgery, Thomas Jefferson University, 1025 Walnut Street, Room 516 College Building, Philadelphia, PA 19107 USA.
authors.forename: Fabio
authors.initials: F
authors.lastname: Orozco
authors.affiliation: Orthopaedic Surgery, Thomas Jefferson University, 1025 Walnut Street, Room 516 College Building, Philadelphia, PA 19107 USA.
authors.forename: Dean C
authors.initials: DC
authors.lastname: Sukin
keywords: Cost; Hip arthroplasty; Outcome; Outpatient