The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Cost-effectiveness of Total Knee Arthroplasty in the United States: Patient Risk and Hospital Volume
Open accessAbstract
BACKGROUND: Total knee arthroplasty (TKA) relieves pain and improves quality of life for persons with advanced knee osteoarthritis. However, to our knowledge, the cost-effectiveness of TKA and the influences of hospital volume and patient risk on TKA cost-effectiveness have not been investigated in the United States. METHODS: We developed a Markov, state-transition, computer simulation model and populated it with Medicare claims data and cost and outcomes data from national and multinational sources. We projected lifetime costs and quality-adjusted life expectancy (QALE) for different risk populations and varied TKA intervention and hospital volume. Cost-effectiveness of TKA was estimated across all patient risk and hospital volume permutations. Finally, we conducted sensitivity analyses to determine various parameters' influences on cost-effectiveness. RESULTS: Overall, TKA increased QALE from 6.822 to 7.957 quality-adjusted life years (QALYs). Lifetime costs rose from $37,100 (no TKA) to $57 900 after TKA, resulting in an incremental cost-effectiveness ratio of $18,300 per QALY. For high-risk patients, TKA increased QALE from 5.713 to 6.594 QALY, yielding a cost-effectiveness ratio of $28,100 per QALY. At all risk levels, TKA was more costly and less effective in low-volume centers than in high-volume centers. Results were insensitive to variations of key input parameters within policy-relevant, clinically plausible ranges. The greatest variations were seen for the quality of life gain after TKA and the cost of TKA. CONCLUSIONS: Total knee arthroplasty appears to be cost-effective in the US Medicare-aged population, as currently practiced across all risk groups. Policy decisions should be made on the basis of available local options for TKA. However, when a high-volume hospital is available, TKAs performed in a high-volume hospital confer even greater value per dollar spent than TKAs performed in low-volume centers.
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Cites
Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030
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The estimation of a preference-based measure of health from the SF-36
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Recommendations of the Panel on Cost-Effectiveness in Health and Medicine
Weinstein, M. C. (1996) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1996.03540150055031 · Cited by 2,455 · cited 3×
“The analysis reported herein conformed to the reference case recommendations of the US Panel on Cost-Effectiveness in Health and Medicine.(22) Outcome measures—including perioperative and longer-term clinical measures, quality-adjusted life expectancy, and direct medical cost (in 2006 US dollars)—were assessed from th…”
MethodInfluentialThe Distinction Between Cost and Charges
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Costs, effects and C/E‐ratios alongside a clinical trial
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The Markov process in medical prognosis
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Handling Uncertainty in Cost-Effectiveness Models
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Fortin, P. R., Clarke, A. E., Joseph, L., Liang, M. H., Tanzer, M., Ferland, D., Phillips, C., Partridge, A. J., B�lisle, P., Fossel, A. H., et al. (1999) · Arthritis & Rheumatism · doi:10.1002/1529-0131(199908)42:8<1722::aid-anr22>3.0.co;2-r · Cited by 711
Self-citationPredicting the Outcome of Total Knee Arthroplasty
Lingard, E. A., Katz, J. N., Wright, E. A., & Sledge, C. B. (2004) · The Journal of Bone & Joint Surgery · doi:10.2106/00004623-200410000-00008 · Cited by 583
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Wallis, J. A., Webster, K. E., Levinger, P., & Taylor, N. F. (2013) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2013.08.003 · Cited by 328
Preoperative predictors of pain following total knee arthroplasty
Noiseux, N. O., Callaghan, J. J., Clark, C. R., Zimmerman, M. B., Sluka, K. A., & Rakel, B. A. (2014) · The Journal of Arthroplasty · doi:10.1016/j.arth.2014.01.034 · Cited by 109
“These studies have led certain agencies and payors to question whether this commonly performed yet expensive operation should be reimbursed in patients with such reported levels of dissatisfaction as their outcome [22].”
Quatman, C. E., Hettrich, C. M., Schmitt, L. C., & Spindler, K. P. (2011) · The American Journal of Sports Medicine · doi:10.1177/0363546511407612 · Cited by 84
Valdes, A. M., Warner, S. C., Harvey, H. L., Fernandes, G. S., Doherty, S., Jenkins, W., Wheeler, M., & Doherty, M. (2015) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2015.05.004 · Cited by 28
Computer Assisted Knee Replacement Surgery: Is the Movement Mainstream?
Picard, F. (2014) · Orthopedic & Muscular System · doi:10.4172/2161-0533.1000153 · Cited by 23
Metadata
- Authors
- Losina, E., Walensky, R. P., Kessler, C. L., Emrani, P. S., Reichmann, W. M., Wright, E. A., Holt, H. L., Solomon, D. H., Yelin, E., Paltiel, A. D., & Katz, J. N.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-06-22
- Volume
- 169
- Issue
- 12
- Pages
- 1113
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1586069835
- Cited by
- 560
- References
- 32
- FWCI
- 26.45
- Type
- journal article
- Language
- en
- Open access
- green
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- Losina, E., Walensky, R. P., Kessler, C. L., Emrani, P. S., Reichmann, W. M., Wright, E. A., Holt, H. L., Solomon, D. H., Yelin, E., Paltiel, A. D., & Katz, J. N. (2009). Cost-effectiveness of Total Knee Arthroplasty in the United States: Patient Risk and Hospital Volume. Archives of Internal Medicine. https://doi.org/10.1001/archinternmed.2009.136
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