Abstract:

The decision point with inter-hospital arthroplasty patient transfers and its financial implications have not been well studied. Factors outside of complexity of medical and surgical care are believed to drive the transfer of orthopaedic patients to tertiary care centers. We compared our institutional cost and resource utilization between transfer and elective patients in need of arthroplasty care. We hypothesized that transfer patients will incur a higher direct cost and resource utilization compared to elective patients, and that socioeconomic factors will play a role in the decision of transfer. After analysis of key metrics, transfer patients at our institution did not have any significant differences in insurance types. However, they did incur a longer length of stay (p<0.0001) and incurred greater direct costs (p<0.0001) to the hospital. After analysis of key parameters, transfer patients were more complex and costly to care for compared to our in-system patients.

Authors:

Peter Hahn, MD, Resident Physician , Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, Ali Qaderi, BSc, Medical Student, Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, James Jung, MD, Resident Physician , Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange CA, Ran Schwarzkopf, MD, MSc, Assistant Professor of Orthopaedic Surgery, Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY

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