Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
J Arthroplasty. 2014 Aug;29(8):1539-44. doi: 10.1016/j.arth.2014.03.015. Epub 2014 Mar 22.
Total joint arthroplasty (TJA) continues to be a popular target of cost control efforts. In order to provide a unique overview of financial trends facing TJA, we analyzed Medicare databases including 100% of beneficiaries, as well as industry surveys of implant list prices. Although there was a substantial increase in TJA utilization over the period 2000-2011 (+26.9%), growth has been stagnant since 2005. New coding schemes have made complicated cases more lucrative for hospitals (+2.5% to 6.5% per year), while reimbursements for uncomplicated cases have fallen (-0.7% to -0.6%). Physician reimbursements have declined on all case types (-2.5% to -2.1% per year), while list prices of orthopedic implants have risen (+4.8% to 5.5%). These trends should be kept in mind while contemplating future changes to TJA payment.
全关节置换术（TJA）仍然是成本控制努力的热门目标。为了提供 TJA 面临的财务趋势的独特概述，我们分析了包括 100%受益人的 Medicare 数据库以及植入物目录价格的行业调查。尽管 2000 年至 2011 年期间 TJA 的使用率大幅增加（增加了 26.9%），但自 2005 年以来增长已经停滞不前。新的编码方案使复杂病例对医院更有利可图（每年增加 2.5% 至 6.5%），而简单病例的报销则下降（每年减少 0.7% 至 0.6%）。所有病例类型的医生报销都有所下降（每年减少 2.5% 至 2.1%），而骨科植入物的目录价格则有所上涨（每年增加 4.8% 至 5.5%）。在考虑 TJA 支付的未来变化时，应该记住这些趋势。
