OBJECTIVES : The Comprehensive Care for Joint Replacement Model (CJR) from the Center for Medicare and Medicaid services (CMS) and similar programs from other payers makes hospitals and healthcare systems more responsible for better clinical and economic outcomes of total hip arthroplasty (THA) patients. The objective of the study was to evaluate hospital-related clinical and economic outcomes of oxidized zirconium hip System in THA patients.

METHODS : We retrospectively reviewed primary THA patients from the Premier Perspective Database between 2014 and 2017. Patients with oxidized zirconium hip System were identified using appropriate keywords from billing records and compared against other THA patients who did not meet the keywords’ criteria. Patients were excluded if they were <21 years of age; outpatient hospital discharges; evidence of revision THA; bilateral THA in same discharge or different discharges. 1:1 Propensity Score Matching was used to control patients, hospital and clinical characteristics. Generalized Estimating Equation (GEE) model with appropriate distribution and link function were used to estimate hospital related cost while logistic regression models were used to estimate discharged status and 30-days readmission.

RESULTS : The study matched 333 Oxidized Zirconium hip system patients with other THA patients. Length of stay for POLAR3 patients (mean=1.61days; CI=1.47-1.74) were significantly lower than other THA patients (mean=2.23days; CI=2.10-2.37). Oxidized Zirconium hip patients were 82% (OR=1.82; CI=1.19-2.78; p-value=0.0058) more likely to be discharged to home/home health care, 44% (OR=0.56; CI=0.35-0.90; p-value=0.0168) less likely to be discharged to a skilled nursing facility, and 65% (OR=0.35; CI=0.12-0.98; p-value=0.0447) less likely to readmitted within 30 days than other THA patients. Mean total hospital costs lower for Oxidized Zirconium hip patients (mean=$15,023; vs $15,451; p-value=0.1803) than other THA patients.

CONCLUSIONS : Hospitals and healthcare professionals can use retrospective real-world data to make informed decisions on hip system choice to reduce hospital cost and improve outcomes in THA patients.