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Clinical and economic characteristics of total hip replacement patients with high health care costs and high health care use

CUI Z; SCHOENFELD M; CHEN Y; BUSH EN; BURGE R
AM J PHYS MED REHABIL , 2015, vol. 94, n° 4, p. 269-279
Doc n°: 174606
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1097/PHM.0000000000000154
Descripteurs : DE361 - TRAITEMENT CHIRURGICAL / HANCHE

The aims of this study were to confirm whether total hip arthroplasty
(THA) patients with muscle atrophy/weakness (MAW) have high health care costs and
resource use and to identify the characteristics that contribute to these high
costs and use. DESIGN: This study analyzed claims from United States patients who
underwent THA identified from commercial (n = 25,249) and Medicare (n = 22,472)
insurance databases to compare demographics, health care costs, and resource use
among patients with or without MAW. The patients were classified into three
separate cohorts: pre-MAW (having MAW during the 12 mos before THA), post-MAW
(having MAW during the 12 mos after THA, and no-MAW (no MAW claim).
Characteristics of the THA patients associated with high health care costs were
examined by multiple logistic regression, and subgroups of patients with high
cost and high resource use were identified by classification and regression tree
analyses. RESULTS: Health care use and costs were significantly higher for the
THA patients with MAW, who had greater likelihood of inpatient and emergency
department use and stays at skilled nursing facilities than the no-MAW patients.
Classification and regression tree identified subgroups of high-cost patients as
those with MAW having extended hospital stays and more outpatient visits.
CONCLUSIONS: THA patients with MAW are at greater risk for high health care costs
and resource consumption, including longer hospital stays, increased outpatient
visits, and stays at skilled nursing and inpatient rehabilitation facilities.

Langue : ANGLAIS

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