What are the Costs of Hip Osteoarthritis in the Year Prior to a Total Hip Arthroplasty (THA)

Abstract Background The majority of the cost-analysis literature on total hip arthroplasties (THAs) has been focused around the peri- and post-operative period, with pre-operative costs being overlooked. Methods The Humana Administrative Claims (HAC) database was used to identify Medicare Advantage (MA) and Commercial beneficiaries undergoing elective primary THAs. Pre-operative healthcare resource utilization in the year prior to a THA was grouped into the following categories: office visits, X-rays, MRIs, CT scans, intra-articular steroid and hyaluronic acid injections, physical therapy and pain medications. Total 1-year costs and Per-patient average reimbursements (PPAR) for each category have been reported. Results Total 1-year pre-operative costs amounted to $21,022,883 (Average = $512/patient) and $4,481,401 (Average = $764/patient) for MA and Commercial beneficiaries, respectively. The largest proportion of total 1-year costs was accounted for by office visits (35% in Commercial; 41% in MA) followed by pain medications (28% in Commercial; 35% in MA). Conservative treatments (steroid injections, HA injections, physical therapy and pain medications) alone accounted for 40%-44% of the total 1-year costs prior to a THA. A high healthcare utilization within the last three months prior to surgery was noted for opioids and steroid injections. Conclusion On average, $500-$800/patient is spent on hip osteoarthritis-related care in the year prior to a THA. Despite their potential risks, opioids and steroid injections are often utilized in the last three months prior to surgery.