Research from the Clarify Health Institute (CHI), a research division of Clarify Health, shows that orthopedic surgeons with higher surgical volumes provided improved patient outcomes in comparison to peers with lower yearly volumes.
Establishing the Connection
According to an article on BusinessWire.com, over 15 million Americans undergo elective surgery annually, with a total cost of around $147.2 billion. As healthcare transitions to a value-based care model, patients increasingly empower themselves to make informed decisions about their healthcare providers. However, there is often a lack of information regarding each surgeon’s surgical volumes. Surgical volumes are widely recognize as an important indicator of the quality of care provided.
“Hip and knee replacements are the most common elective orthopedic surgeries where it is possible for patients to choose their provider,” CHI’s Chief Analytics and Privacy Officer Niall Brennan told BusinessWire. “Thousands of adverse clinical events could be avoided each year by making surgical volume information easily accessible and steering patients to high-volume providers.”
CHI aimed to expand its study beyond previous inquiries to further explore the connection between surgical volume and patient outcomes. Typically, these inquiries focused on small sample sizes for specific surgical procedures.
Study Findings & Results
The study reviewed insurance claims from 2017 to 2020, organizing providers via surgical volume. The categorization of low volume was assigned to surgeons conducting fewer than 10 surgeries in the timeframe. Conversely, surgeons conducting more than 100 procedures were categorized as high volume. The data also included patients who underwent total hip arthroplasties (THA) and total knee arthroplasties (TKA) in 2021. The study analyzed 178,000 orthopedic procedures, representing approximately 14% of annual knee and hip replacements in the United States.
Some major findings from the report included:
- Surgeons with increased procedure volumes within the selected timeframe showed decreased instances of negative patient outcomes, regardless of the site of care.
- Patients who received care from surgeons with higher volumes saw lower rates of hospital readmission at 7- and 60-days post-procedure, and lower rate of surgery revisions.
- Data showed that, that surgeons who had performed less than 10 procedures within the sampled date range (2017-2020) completed many hip and knee replacement procedures in 2021.
- Rates of negative outcomes for hip and knee procedures performed in outpatient and ambulatory surgery center (ASC) settings were 13%-24% and 27%-45% lower respectively in comparison to procedures performed in an inpatient setting.
According to Clarify Health’s brief, patients experienced benefits from high-volume surgeons. However, it highlights that high acuity patients, who require repeated visits and procedures for their health, witnessed even greater improvements. However, the brief does state that higher-risk patients may still benefit most from inpatient, traditional hospital settings.
Higher Volumes and Improved Outcomes
“There is a clear linear relationship—the more operations a surgeon performs, the better the patient does,” said Ezekiel Emanuel, M.D., Vice Provost for Global Initiatives at the University of Pennsylvania, co-director of Healthcare Transformation Institute, and a strategic advisor to Clarify Health. “If we shift more patients to get their hip and knee replacements by high-volume surgeons, it will be a huge win-win. Patients will win with fewer complications, fewer revisions, and fewer hospital readmissions, and the system will win by having lower costs. Now the challenge is to shift patients to see more experienced surgeons.”
One factor in expediting the shift to higher volume surgeons involves the increased accessibility of information for patients. In a time where patients are choosing to shop for lower costs and higher quality care prior to undergoing a procedure, providing surgeon volumes becomes crucial. This information enables a more informed and prepared patient population.
How We Can Help
SCA Health is more than just an ASC management company. We work to ensure that physicians have a safe environment to perform their procedures and deliver high-quality care to patients.
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