The Financial Impact of a Multidisciplinary Preoperative Risk Stratification Program for Joint Arthroplasty

J Arthroplasty. 2015 Sep;30(9):1485-91. doi: 10.1016/j.arth.2015.04.014. Epub 2015 Apr 11.


This study's purpose was to assess the impact of a preoperative risk stratification program on joint arthroplasty outcomes at a single institution. We hypothesized that by using a standardized preoperative risk stratification center we would see better outcomes and decreased costs. The triage cohort (T) included 1498 patients assessed at a standardized risk stratification center, and the non-triage cohort (NT) included 1100 patients who did not utilize the center. The T cohort had significantly higher ASA classification (P<0.0001) and ACCI scores (P=0.028). We found no significant difference in complication rates. The T cohort showed a significant decrease in LOS (P<0.0001) and an increase in average reimbursement (P=0.009). A standardized preoperative risk stratification center can contribute to decreased LOS, increased reimbursement and help prevent complications.

Keywords: arthroplasty; cost; efficiency; hip; knee; standardization.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / economics*
  • Arthroplasty, Replacement, Knee / economics*
  • Cohort Studies
  • Economics, Medical
  • Female
  • Health Care Costs
  • Humans
  • Insurance, Health
  • Length of Stay
  • Male
  • Middle Aged
  • Reimbursement Mechanisms
  • Risk Assessment / methods*
  • Risk Factors
  • Triage