Variation in TKA & THA Rates

The rate at which surgeons perform hip and knee replacements as well as spine surgery varies widely among academic medical centers, according to a study by the Dartmouth Atlas Project. The results were reported by Sabrina Rodak, writing for Becker’s Spine Review.

Inpatient surgical procedure rates per 1, 000 Medicare enrollees from 2008 to 2010 in 19 hospitals varied from 2.3 hip replacements in Los Angeles to 5.8 in Rochester, Minnesota. The national average was 3.8. The variation was greater in knee replacement rates. With the national average at 8.8, the rate in San Francisco was 4.3 while in Salt Lake City it was 11.9. Back surgery rates varied from 2.4 in Temple, Texas, to 6.3 in Nashville, Tennessee. The national average was 4.7.

The report, titled “What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training, ” was intended to guide medical residents in their choice of teaching hospitals. “A resident trained in Salt Lake City may be more likely to learn a treatment style involving surgery than in New York City, where a resident might more readily prescribe physical therapy, ” advised the authors of the report.