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
DOI: 10.1177/1120700020952776
Background
The shift to outpatient surgery for total hip arthroplasty (THA) is growing, but its cost-effectiveness compared to inpatient surgery is unclear. This study analyzes the cost-effectiveness of outpatient THA versus inpatient THA in the U.S.
Methods
A cost-effectiveness analysis was performed using a computer model. The effectiveness of outpatient THA was compared to inpatient THA over a lifetime, using quality-adjusted life years (QALYs) and Medicare/private insurance costs.
Key Findings
Outpatient THA was more cost-effective than inpatient THA, with an incremental cost-effectiveness ratio (ICER) above the commonly accepted $50,000 per QALY threshold.
Inpatient THA was more costly but had slightly more utility (QALYs) than outpatient THA.
Sensitivity analyses showed that the cost of inpatient and outpatient surgeries and the utility of each treatment were key factors.
Conclusions
Outpatient THA is more cost-effective than inpatient THA for patients, based on a $50,000/QALY threshold. However, surgeons must consider clinical factors when deciding whether outpatient surgery is suitable for an individual patient.
What Does This Mean for Patients
If you're having a hip replacement and are eligible for outpatient surgery, this could save costs and potentially lead to quicker recovery, as it is more cost-effective than inpatient surgery.