Symposium: ABJS Carl T. Brighton Workshop on Health Policy Issues in Orthopaedic Surgery

Clinical Orthopaedics and Related Research®

, Volume 467, Issue 10, pp 2577-2586

The Impact of Physician-owned Specialty Orthopaedic Hospitals on Surgical Volume and Case Complexity in Competing Hospitals

  • Xin LuAffiliated withDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City VA Medical Center
  • , Tyson P. HagenAffiliated withDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City VA Medical CenterCenter for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center
  • , Mary S. Vaughan-SarrazinAffiliated withDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City VA Medical CenterCenter for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center
  • , Peter CramAffiliated withDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City VA Medical CenterCenter for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center Email author 

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Abstract

Published studies of physician-owned specialty hospitals have typically examined the impact of these hospitals on disparities, quality, and utilization at a national level. Our objective was to examine the impact of newly opened physician-owned specialty orthopaedic hospitals on individual competing general hospitals. We used Medicare Part A administrative data to identify all physician-owned specialty orthopaedic hospitals performing total hip arthroplasty (THA) and total knee arthroplasty (TKA) between 1991 and 2005. We identified newly opened specialty hospitals in three representative markets (Durham, NC, Kansas City, and Oklahoma City) and assessed their impact on surgical volume and patient case complexity for the five competing general hospitals located closest to each specialty hospital. The average general hospital maintained THA and TKA volume following the opening of the specialty hospitals. The average general hospital also did not experience an increase in patient case complexity. Thus, based on these three markets, we found no clear evidence that entry of physician-owned specialty orthopaedic hospitals resulted in declines in THA or TKA volume or increases in patient case complexity for the average competing general hospital.