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The Journal of Bone and Joint Surgery, Vol 75, Issue 3 321-325, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
The hospital cost of total hip arthroplasty. A comparison between 1981 and 1990
TC Barber and WL Healy
Department of Orthopaedic Surgery, Lahey Clinic, Burlington, Massachusetts 01805.
The change in the hospital cost of total hip arthroplasty over a ten-year
period at the Lahey Clinic was evaluated by comparison of the hospital
bills for forty-four hip replacements that had been performed in 1981 with
the bills for 104 such operations that had been done in 1990. Each hospital
charge was converted to cost with use of government-mandated
hospital-specific cost-to-charge ratios. The average actual hospital cost
for total hip arthroplasty increased 46.5 per cent, from $8428 in 1981 to
$12,348 in 1990. However, in inflation-adjusted dollars, the cost increased
only 1.9 per cent. During this period, the cost for a patient room
decreased from 50 per cent of the hospital cost in 1981 to 37 per cent of
the hospital cost in 1990. In sharp contrast, the cost of hip prostheses
increased from 11 per cent of the hospital cost in 1981 to 24 per cent of
the hospital cost in 1990. The actual dollar cost of the hip prostheses
increased 212 per cent, and the inflation-adjusted dollar cost increased
117 per cent. The hospital cost of total hip arthroplasty during the 1980's
was controlled by decreases in the length of stay in the hospital and in
the volume of services delivered. The unit costs of supplies and,
specifically, the cost of hip prostheses were not controlled. In the
1990's, efforts to control the hospital cost of total hip arthroplasty must
concentrate on decreasing the cost of the prostheses and on controlling the
unit costs of personnel and of hospital supplies.
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