The epidemiology of primary and revision total hip arthroplasty in teaching and nonteaching hospitals in the United States

Thomas D. Kowalik, Matthew De Hart, Hanne Gehling, Paxton Gehling, Kathryn Schabel, Paul Duwelius, Amer Mirza

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Introduction: The purpose of this study was to examine the epidemiology of primary and revision total hip arthroplasty (THA) in teaching and nonteaching hospitals. Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried from 2006 to 2010 to identify primary and revision THAs at teaching and nonteaching hospitals. Results: A total of 1,336,396 primary and 223,520 revision procedures were identified. Forty-six percent of all primary and 54% of all revision procedures were performed at teaching hospitals. Teaching hospitals performed 17% of their THAs as revisions; nonteaching hospitals performed 12% as revisions. For primary and revision THAs, teaching hospitals had fewer patients aged >65 years, fewer Medicare patients, similar gender rates, more nonwhite patients, and more patients in the highest income quartile compared with nonteaching hospitals. Costs, length of stay, and Charlson Comorbidity Index scores were similar; however, the mortality rate was lower at teaching hospitals. Conclusions: This study found small but significant differences in key epidemiologic and outcome variables in examining primary and revision THA at teaching and nonteaching hospitals. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)393-398
Number of pages6
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2016

Keywords

  • epidemiology
  • nationwide inpatient sample
  • revision
  • teaching hospital
  • THA
  • total hip arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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