Variations In Care – Hip and Knee Replacement

AHIA is concerned to make sure that members get the best possible care. Figures show large variations in care across states.  For example, why is it that not enough hip replacements are done in some states whilst in others too many are performed?

Hip and knee replacement  is the most expensive category of surgical procedures in the private health sector. The demand for  those procedure is increasing  in line with growing number of patients with osteoarthritis and arthrithis. The joint replacement is the most commonly suggested treatment for these conditions.

Hip Replacement

In 2009-2010, there was 69,150 hip replacements performed in the private hospitals across Australia, an increase of 10.9% on the last financial year. The total benefits paid by health funds  for hip prosthesis increased by 9.1% from last financial year, growing from $163 million in 2008-2009 to $178 million in 2009-2010. (PHIAC – ‘Annual Report 2009-2010’)

• In 2009-2010, the highest rate for primary hip replacement procedure was in SA, followed by TAS, ACT and VIC.
• The Average Length of Stay varied from 5.6 days in ACT to 7.4 days in WA for cases without complications and from 8.2 days in ACT to 23 days in WA for cases with complications.
• The average benefits paid including cost of hip prosthesis was the highest in VIC reaching more than $24,000 per episode without complications.
• The lowest cost for the same type of episode was in ACT and QLD.
• The highest rates for procedures with complications related to hip replacement surgery was in SA and the lowest in NSW.

Knee Replacement

Knee replacement is a very common surgery. In 2009-2010, the overall number of hospital episodes related to knee replacement was higher by 13.1% than the previous year, reaching 84,585 knee replacements. The total benefit paid for knee prosthesis was $187 million, 11% greater than last financial year. (PHIAC – ‘Annual Report 2009-2010’)

• In 2009-2010, SA had also the highest rate for knee replacement, followed by WA, VIC, TAS and ACT.
• In SA out of 100 000 of populations more than 100 patients had the primary knee replacement.
• The highest rate of cases with complications was in ACT and SA.
• The Average Length of stay in private hospitals was the lowest in ACT, 4.9 days and the highest in WA, 7.7 days.
• The highest benefits were paid in WA ranging from around $20,600 per episode with complications to around $19,500 for episode without complications.
• The benefits paid were the lowest in ACT, both for episode with and without complications.

Tags: CPRU, Hip Replacement, Knee Replacment, Safety and Quality, Surgery, Variations in Care, Uncategorized