Impact of a value-oriented care purchasing process for total joint arthroplasty

Company X has developed a value-orientated care purchasing process (VOP) to increase quality of care and reduce healthcare costs. This study will try to assess if VOP for knee and hip arthroplasty contributes to a higher value of healthcare. For readmission, revision and infections, logistic regression was used to identify the effect of VOP on selected outcomes. A multilevel analysis was used to identify the effect of VOP on hospital days, imaging activities and outpatient visits. Outcomes after knee arthroplasty show that patients treated in a VOP hospital have a non-significant higher chance of readmissions, infections, having more than five hospital days and more than two imaging activities. However, they also have a non-significant lower chance of revisions and having more than three outpatient visits. For hip arthroplasty, results show that patients treated in a VOP hospital experience a non-significant higher chance of readmissions, revisions, infections, more than five hospital days and more than two imaging activities but a non-significant lower chance of having more than three outpatient visits. There is suggested to examine the effects of VOP for a longer period, to include qualitative outcome measures and to obtain data from the total knee and hip arthroplasty care pathway.