In-hospital outcomes and hospital resource utilization of hip replacement procedures

Background: Although the incidence of hip replacement surgery is rapidly increasing, there are few data describing the hospital resource utilization associated with these procedures. We aimed to examine the in-hospital outcomes and resource utilization of primary and revision hip replacement. Methods: We analysed data from the 2005/2006 Victorian Admitted Episodes Database that included one or more of the International Classification of Diseases procedure codes for hip replacement. Demographic parameters and in-hospital outcomes, including length of stay, duration of intensive/coronary care and discharge destination, were examined. Results: A total of, 7724 separations had a hip replacement. Primary procedures accounted for 86.8% of all separations. Of these, 79.3% were total hip replacements and the remainder were partial hip replacements. Most partial hips were managed (81.6%) and funded (60.0%) within the public system, whereas revisions were largely managed privately (59.0%). Revisions had less satisfactory outcomes than primary total hips, with 22.9% more revisions remaining in hospital for more than a week (P < 0.0001), 14.6% more requiring intensive care (P < 0.0001) and 10.9% less being discharged to a private residence (P < 0.001) (adjusting for confounders). Although primary partial and revision replacements accounted for only 16.8 and 13.2% of all hip replacements, they utilised up to 27.5 and 34.6% of hospital resources, respectively. Conclusion: Partial and revision hip replacements are resource intensive for the public and private health-care systems, respectively. It is imperative that strategies to reduce the incidence of these procedures are implemented, as failure to do so will have important implications for the allocation of health-care funding.