The Financial Impact of a Multidisciplinary Preoperative Risk Stratification Program for Joint Arthroplasty.
This study's purpose was to assess the impact of a preoperative risk stratification program on joint arthroplasty outcomes at a single institution. We hypothesized that by using a standardized preoperative risk stratification center we would see better outcomes and decreased costs. The triage cohort (T) included 1498 patients assessed at a standardized risk stratification center, and the non-triage cohort (NT) included 1100 patients who did not utilize the center. The T cohort had significantly higher ASA classification (P<0.0001) and ACCI scores (P=0.028). We found no significant difference in complication rates. The T cohort showed a significant decrease in LOS (P<0.0001) and an increase in average reimbursement (P=0.009). A standardized preoperative risk stratification center can contribute to decreased LOS, increased reimbursement and help prevent complications.
Department of Orthopaedic Surgery, Ochsner Health System, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
Neil
N
Duplantier
Department of Orthopaedic Surgery, Ochsner Health System, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
David
D
Briski
Department of Orthopaedic Surgery, Ochsner Health System, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
John Lockwood
JL
Ochsner
Department of Orthopaedic Surgery, Ochsner Health System, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
Mark
M
Meyer
Covington Orthopedics Sports Medicine Institute, Covington, Louisiana.
Daryl
D
Stanga
Department of Orthopaedic Surgery, Ochsner Health System, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
George F
GF
Chimento
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D015331:Cohort Studies; D004470:Economics, Medical; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012051:Reimbursement Mechanisms; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014218:Triage
arthroplasty; cost; efficiency; hip; knee; standardization