Report: Outpatient orthopedic procedures on the rise

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A report by PHC4 shows certain orthopedic procedures are being increasingly performed in outpatient settings.  

The report, which shows outcome and volume information for common orthopedic procedures, includes outpatient facilities for the first time, PHC4, an independent state agency that addresses rapidly growing health care costs, said. 

The report shows that from the fourth quarter 2020 to the third quarter 2022, the number of inpatient spinal fusion cases decreased 8.8% while the number of outpatient cases increased 1%. 

For hip replacements, the number of outpatient cases increased 113.7% while the number of inpatient cases decreased 52.3% and the number of outpatient knee replacements increased 74.3% while inpatient cases decreased 53.1%. 

Patients receiving inpatient procedures stayed in the hospital an average of 3.3 days for spinal fusions with 2.4% experiencing extended postoperative stays of an average of 12.8 days, the report shows. 

For total hip replacement, the average inpatient postoperative length of stay was 1.7 days. with 4.3% of patients experiencing an extended postoperative length of stay of 6.4 days. For total knee replacement, the average inpatient postoperative length of stay was 1.8 days, with 3.3% of patients experiencing an extended postoperative length of stay averaging 6.4 days. 

Two percent of patients experienced complications from an in-hospital spinal fusion and 2.3% were readmitted to an acute care hospital for a complication within 7, 30, or 90 days of discharge depending on the complication, the report shows. 

 For total hip replacement, 2.8% of patients had an in-hospital complication or were readmitted to an acute care hospital for a complication within 7, 30, or 90 days of discharge depending on the complication. 

For total knee replacement, 1.7% of patients had an in-hospital complication or were readmitted to an acute care hospital for a complication within 7, 30, or 90 days of discharge depending on the complication. 

PHC4 said it believes this report serves as an informative tool to assist consumers and purchasers in making more informed health care decisions. Additionally, the organization hopes it will serve as an aid to providers in highlighting opportunities for quality improvement. 

 “Producing this information for stakeholders has always provided value,” said Barry Buckingham, PHC4’s executive director. “The ability to add outpatient encounters to the CPR is one more way for PHC4 to support informed decision-making and healthcare professionals.”