A recent study compared patient cost and outcomes for inpatient hip and knee replacement surgeries to those performed in an ambulatory surgery center. It found no increased risk of 90-day complication rates or readmission rates for patients who went home the same day compared to patients in a hospital.
Michael P. Ast, M.D., hip and knee replacement surgeon at Hospital for Special Surgery, conducted a study with colleagues, including Alvin C. Ong, M.D., at the Rothman Orthopedic Institute. Dr. Ong performed inpatient hip and knee replacement procedures at a university medical center, and Dr. Ast conducted similar procedures on an outpatient basis at a local ambulatory surgery center.
ASCs Produce Shorter Stays and Lower Infection Rates
The surgeons analyzed data from 126 patients in each group, based on similar procedure, sex, age, body mass and health assessment. The outpatient group had a much shorter average length of stay: 8:09 hours compared to 23:24 hours for the inpatient group. The ambulatory group also had a lower rate of infection at 2.4 percent, whereas the inpatient group was at 3.9 percent.
ASCs Offer Cost Savings
Most patients are concerned about hip and knee replacement surgery costs, but many are not aware that outpatient surgery is an option. Dr. Ong and Dr. Ast found the average cost of total joint replacement among patients at the local ASC was $11,677, about 40 percent less than the $19,361 average cost for the inpatient procedure at the university medical center. This data is consistent with a 2016 article in Orthopedic Reviews, which estimated patients would save 17.6 to 57.6 percent by scheduling an orthopedic procedure at an ASC instead of a hospital.
ASCs and the Future of Healthcare
Total joint replacement surgeries are expected to rise each year, but currently, only about five percent of total hip and total knee replacements occur at ASCs. By 2030, there will be an estimated 635,000 hip replacements and 1.28 million knee replacements. Choosing an ASC instead of a hospital has the potential to lower individual spending and affect the trajectory of the entire healthcare industry.
If you are in good health and are at low risk for heart disease, blood clots or post-surgical complications, you could be an excellent candidate for total joint replacement at an ambulatory surgery center. Ask your doctor for a list of in-network ambulatory surgery centers for your knee or hip replacement.