Variation in use of reverse total shoulder arthroplasty across hospitals

Boguski, Robert M.; Miller, Bruce S.; Carpenter, James E.; Mendenhall, Stanley; Hughes, R.

doi:10.1016/j.jse.2013.09.002

Cited by 11 publications

(7 citation statements)

References 8 publications

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“…Similar to other studies within orthopedic surgery, 3,11,24,34 there was great variability in cost for syndactyly procedures among pediatric hospitals across the United States. This highlights an opportunity to provide improved value by identifying best practices which produce equivalent or better clinical outcomes at lower costs.…”

Section: Discussionsupporting

confidence: 67%

Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Canizares

Feldman

Miller

et al. 2016

Hand (New York, N,Y.)

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Section: Discussionsupporting

confidence: 67%

Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Canizares

Feldman

Miller

et al. 2016

Hand (New York, N,Y.)

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“…Boguski et al used 2012 data on 3,119 shoulder arthroplasty cases from 100 hospitals in 18 states to characterize variation in utilization of reverse shoulder arthroplasty across hospitals and the effect of hospital volume on this variation 1 . They reported wide variation between 0% and 100% (mean of 42.3%) in the use of reverse shoulder arthroplasty across hospitals.…”

Section: Discussionmentioning

confidence: 99%

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

Jain

Yamaguchi

2014

Journal of Shoulder and Elbow Surgery

126

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Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty, and present age and sex stratified national rates of shoulder arthroplasty. We also assessed contemporary complication rates, mortality, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009–2011 to calculate estimates of shoulder arthroplasty and assessed trends using joinpoint regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (total anatomical, hemi, and reverse) increased significantly from 52,397 procedures (95% CI=47,093–57,701) in 2009 to 67,184 cases (95% CI=60,638–73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The diagnosis of concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75–84 year female sub-group (77; 95% CI=67–87). Revision cases were 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were secondary to mechanical complications/loosening while 18% were due to dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a three year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded as a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed. Level of evidence Epidemiology Study, Database Analysis

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“…5 A reasonable explanation for this comes from a recent study of TSA supply chain data by Boguski et al Their data showed that in high-volume hospitals, a larger percentage of shoulder replacements are reverse shoulder replacements compared with the lower volume hospitals. 3 This could explain the higher charges at these hospitals as reverse shoulder arthroplasties cost more than anatomic shoulder replacements. 7 Whereas this study does highlight some interesting findings related to hospital charges for TSA, there are limitations.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting hospital charges after total shoulder arthroplasty: an evaluation of the National Inpatient Sample database

Davis

Paxton

Maltenfort

et al. 2014

Journal of Shoulder and Elbow Surgery

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Variation in use of reverse total shoulder arthroplasty across hospitals

Cited by 11 publications

References 8 publications

Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

Factors affecting hospital charges after total shoulder arthroplasty: an evaluation of the National Inpatient Sample database

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