The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty Academic Article uri icon


MeSH Major

  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Delivery of Health Care
  • Healthcare Disparities
  • Hospitals, High-Volume


  • Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, 2,560,314 patients who underwent primary total hip or knee arthroplasty from 1991 to 2006 were categorized by whether an HVH (>200 annual TJAs) was available locally. Associations among patient characteristics, hospital utilization, and in-hospital complications were estimated using regression modeling. The complication risk was higher (Odds Ratio 1.18 [95% CI: 1.16, 1.20]) if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks. However, patients from vulnerable groups were less likely to utilize these patterns.

publication date

  • January 2015



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.arth.2014.08.017

PubMed ID

  • 25282073

Additional Document Info

start page

  • 1

end page

  • 6


  • 30


  • 1