Utilization of total ankle replacement (TAR) has increased in the United States over the last 20 years. In collaboration with Dr. Sudheer Reddy, we investigated the variation in TAR utilization across hospitals and hospital characteristics associated with that variation. We primarily focused on inpatient costs as it related to primary TAR. Data from the Nationwide Inpatient Sample was used to examine description statistics on all TAR patients. We used Medicare Inpatient Limited Data Sets and cost reports to calculate overall hospital all-payer margins and cost-to-charge ratios associated with overall services and “implantable devices” to compute the cost of surgery and the prosthesis, respectively. We found a significant financial burden on utilizing TAR as many health systems have been unable to generate profits despite an increased number of surgeries.
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