The Cost-Effectiveness of Outpatient Surgery for Primary Total Hip Arthroplasty in the United States: A Computer-Based Cost-Utility Study
Authors: Rosinsky PJ, Go CC, Bheem R, Shapira J, Maldonado DR, Meghpara MB, Lall AC, Domb BG
Background
The rise of outpatient total hip arthroplasty (THA) necessitates analysis of its cost-effectiveness compared to inpatient THA.
Methods
A computer simulation model evaluated lifetime cost-effectiveness of outpatient vs. inpatient THA using quality-adjusted life years (QALYs) and Medicare/private payer costs.
Key Findings
- Outpatient THA is more cost-effective relative to inpatient THA based on the $50,000/QALY willingness-to-pay threshold.
- Inpatient THA had slightly higher utility (QALYs) but was substantially more expensive.
- Cost inputs and utility values heavily influenced the model’s sensitivity.
Conclusions
Outpatient THA offers cost savings and good value for healthcare systems and patients, though patient selection and clinical judgment remain crucial.
What Does This Mean for Providers?
Consider outpatient THA as a cost-effective treatment strategy for appropriate candidates. Incorporate clinical criteria and patient comorbidities when deciding surgical setting to optimize outcomes and resource utilization.