title: The incremental hospital cost and length-of-stay associated with treating adverse events among Medicare beneficiaries undergoing TKA.
abstract: This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing TKA. This retrospective study, using the Medicare Provider Analysis and Review file, identified 353,650 Medicare beneficiaries who underwent a primary TKA during 2011. Overall, 11.82% of Medicare beneficiaries (MBs) undergoing TKA experienced at least one of the study's adverse events. MBs experiencing any adverse event consumed significantly more unadjusted hospital resources ($3110 cost) and had longer stays (1.3 days). The risk-adjusting incremental cost of treating adverse events ranged between $30,902 (pneumonia) and $2167 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occur infrequently; however when an adverse event occurs following TKA, it adds substantially to hospital costs.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Culler
authors.affiliation: Medical Director of Orthopedic Clinical Program, Intermountain Healthcare, St. George, Utah.
authors.forename: David S
authors.initials: DS
authors.lastname: Jevsevar
authors.affiliation: St Lukes Health System, Boise, Idaho; Department of Orthopedics, University of Utah, Salt Lake, Utah.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Shea
authors.affiliation: OrthoDataSolutions, a Division of Cardiac Data Solutions, Inc., Atlanta, Georgia.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Wright
authors.affiliation: OrthoDataSolutions, a Division of Cardiac Data Solutions, Inc., Atlanta, Georgia.
authors.forename: April W
authors.initials: AW
authors.lastname: Simon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000191:economics / Q000601:surgery*; D012189:Retrospective Studies; D014481:United States
keywords: Medicare beneficiaries; TKA; adverse events; hospital cost; length-of-stay