Shichman Ittai, Askew Neil, Habibi Akram, Nherera Leo, Macaulay William, Seyler Thorsten, Schwarzkopf Ran
Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
Division of Orthopedic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Arthroplast Today. 2023 May 30;21:101152. doi: 10.1016/j.artd.2023.101152. eCollection 2023 Jun.
National projections of future joint arthroplasties are useful in understanding the changing burden of surgery and related outcomes on the health system. The aim of this study is to update the literature by producing Medicare projections for revision total joint arthroplasty procedures from 2040 through 2060.
The study uses 2000-2019 data from the CMS Medicare Part-B National Summary and combines procedure counts using CPT codes for revision total joint arthroplasty procedures. In 2019, revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) procedures totaled 53,217 and 30,541, respectively, forming a baseline from which we generated point forecasts between 2020 and 2060 and 95% forecast intervals (FI).
On average, the model projects an annual growth rate of 1.77% for rTHAs and 4.67% for rTKAs. By 2040, rTHAs were projected to be 43,514 (95% FI = 37,429-50,589) and rTKAs were projected to be 115,147 (95% FI = 105,640-125,510). By 2060, rTHAs was projected to be 61,764 (95% FI = 49,927-76,408) and rTKAs were projected to be 286,740 (95% FI = 253,882-323,852).
Based on 2019 total volume counts, the log-linear exponential model forecasts an increase in rTHA procedures of 42% by 2040 and 101% by 2060. Similarly, the estimated increase for rTKA is projected to be 149% by 2040 and 520% by 2060. An accurate projection of future revision procedure demands is important to understand future healthcare utilization and surgeon demand. This finding is only applicable to the Medicare population and demands further analysis for other population groups.
对未来关节置换手术的全国性预测有助于了解手术负担的变化以及对卫生系统的相关影响。本研究的目的是通过对2040年至2060年翻修全关节置换手术的医疗保险数据进行预测来更新相关文献。
本研究使用了医疗保险和医疗补助服务中心（CMS）医疗保险B部分全国总结中的2000 - 2019年数据，并结合使用现行程序编码（CPT）对翻修全关节置换手术的手术例数进行统计。2019年，翻修全膝关节置换术（rTKA）和翻修全髋关节置换术（rTHA）的手术例数分别为53,217例和30,541例，以此为基线，我们生成了2020年至2060年的点预测以及95%的预测区间（FI）。
平均而言，该模型预测rTHA的年增长率为1.77%，rTKA的年增长率为4.67%。到2040年，预计rTHA的手术例数将达到43,514例（95%预测区间 = 37,429 - 50,589例），rTKA的手术例数将达到115,147例（95%预测区间 = 105,640 - 125,510例）。到2060年，预计rTHA的手术例数将达到61,764例（95%预测区间 = 49,927 - 76,408例），rTKA的手术例数将达到286,740例（95%预测区间 = 253,882 - 323,852例）。
基于2019年的总量统计，对数线性指数模型预测到2040年rTHA手术例数将增加42%，到2060年将增加101%。同样，预计到2040年rTKA的手术例数增加149%，到2060年增加520%。准确预测未来翻修手术需求对于了解未来医疗保健利用情况和外科医生需求至关重要。这一发现仅适用于医疗保险人群，其他人群组还需要进一步分析。
