Effect of price capitation on implant selection for primary total hip and knee arthroplasty

J Arthroplasty. 2014 Jul;29(7):1345-9. doi: 10.1016/j.arth.2014.02.020. Epub 2014 Feb 26.

Abstract

While price capitation strategies may help to control total hip (THA) and knee arthroplasty (TKA) implant costs, its effect on premium implant selection is unclear. Primary THA and TKA cases 6 months before and after capitated pricing implementation were retrospectively identified. After exclusions, 716 THA and 981 TKA from a large academic hospital and 2 midsize private practice community hospitals were reviewed. Academic hospital surgeons increased premium THA implant usage (66.5% to 70.6%; P = 0.28), while community surgeons selected fewer premium implants (36.4%) compared to academic surgeons, with no practice change (P = 0.95). Conversely, premium TKA implant usage significantly increased (73.4% to 89.4%; P < 0.001) for academic surgeons. Community surgeons used premium TKA implants at greater rates in both periods, with all cases having ≥1 premium criterion.

Keywords: implant selection; premium implants; price capitation; total hip arthroplasty; total knee arthroplasty.

MeSH terms

  • Academic Medical Centers / economics
  • Aged
  • Arthroplasty, Replacement, Hip / economics*
  • Arthroplasty, Replacement, Knee / economics*
  • Capitation Fee*
  • Economics, Hospital
  • Female
  • Hospitals
  • Hospitals, Community / economics
  • Humans
  • Male
  • Middle Aged
  • Prostheses and Implants / economics
  • Retrospective Studies
  • United States