PMID- 28366314
OWN - NLM
STAT- MEDLINE
DCOM- 20180321
LR  - 20181202
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 32
IP  - 7
DP  - 2017 Jul
TI  - Utilization of Total Joint Arthroplasty in Physician-Owned Specialty Hospitals vs 
      Acute Care Facilities.
PG  - 2060-2064.e1
LID - S0883-5403(17)30173-0 [pii]
LID - 10.1016/j.arth.2017.02.055 [doi]
AB  - BACKGROUND: The recent emergence of physician-owned specialty hospitals has 
      sparked controversy about overutilization. Thus, the purpose of this study was to 
      compare utilization patterns of total joint arthroplasty (TJA) between 
      physician-specialty hospitals (PSHs) and acute care hospitals (ACHs). METHODS: A 
      retrospective study was conducted from January 2010 to August 2014 comparing 
      primary TJA patients between a PSH and an ACH; 103 PSH patients were matched to 
      103 ACH patients by age, gender, BMI, and ASA classification with similar case 
      distribution between facilities. All surgeons in the study operated at both 
      hospitals and were shareholders of the PSH. Information on nonoperative 
      treatments, and timing to the initial appointment, consent, and surgery were 
      analyzed using univariate analysis. RESULTS: Nonoperative treatments before 
      surgery were similar between hospitals (P = 1.00). The time from the initial 
      appointment to consent was longer for PSH (P = .0001). However, the time from 
      consent to the date of surgery (P = .04) and the timing from symptoms to initial 
      appointment (P = .006) was shorter for PSH. The time from initial appointment to 
      the day of surgery was similar between groups (P = .20). Patients were more 
      likely to be consented for surgery on their first clinic visit when undergoing 
      surgery at ACH (87 of 103, 84.4%) compared to PSH (61 of 103; 59.2%; P < .001). 
      Length of stay was significantly shorter for both total knee arthroplasty (P = 
      .001) and total hip arthroplasty patients (P = .001) at PSH. CONCLUSION: Facility 
      ownership in PSH resulted in similar conservative treatment before TJA. The time 
      to surgical consent after the initial appointment was longer PSH, whereas the 
      time from consent to the date of surgery was shorter at the PSH.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Chen, Antonia F
AU  - Chen AF
AD  - Rothman Institute, Philadelphia, Pennsylvania.
FAU - Pflug, Emily
AU  - Pflug E
AD  - Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
FAU - O'Brien, Daniel
AU  - O'Brien D
AD  - Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
FAU - Maltenfort, Mitchell G
AU  - Maltenfort MG
AD  - Rothman Institute, Philadelphia, Pennsylvania.
FAU - Parvizi, Javad
AU  - Parvizi J
AD  - Rothman Institute, Philadelphia, Pennsylvania.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170319
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Hip/*statistics & numerical data
MH  - Arthroplasty, Replacement, Knee/*statistics & numerical data
MH  - Critical Care
MH  - Female
MH  - Hospitals
MH  - Hospitals, Group Practice/*statistics & numerical data
MH  - Hospitals, Special
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ownership
MH  - Physicians
MH  - Retrospective Studies
OTO - NOTNLM
OT  - acute care facilities
OT  - conservative treatment
OT  - physician-owned specialty hospitals
OT  - time to surgery
OT  - total joint arthroplasty
EDAT- 2017/04/04 06:00
MHDA- 2018/03/22 06:00
CRDT- 2017/04/04 06:00
PHST- 2015/11/23 00:00 [received]
PHST- 2017/02/09 00:00 [revised]
PHST- 2017/02/20 00:00 [accepted]
PHST- 2017/04/04 06:00 [pubmed]
PHST- 2018/03/22 06:00 [medline]
PHST- 2017/04/04 06:00 [entrez]
AID - S0883-5403(17)30173-0 [pii]
AID - 10.1016/j.arth.2017.02.055 [doi]
PST - ppublish
SO  - J Arthroplasty. 2017 Jul;32(7):2060-2064.e1. doi: 10.1016/j.arth.2017.02.055. 
      Epub 2017 Mar 19.