New study finds annual volume a key influential factor in knee replacement readmission rates

Using data from Hospital Episode Statistics, the Dr Foster team analysed a total of 521,858 elective primary knee replacement surgeries in order to examine the effect of provider annual volume on the outcome of 28-day readmissions post-operation. The surgeries all took place between April 2010 and March 2019.

The analysis revealed annual volume influenced readmissions at a 90 per cent confidence level, suggesting an increase in the volume of knee replacements for providers would decrease the likelihood of costly readmission following surgery and provide better outcomes for patients.

The data used in the analysis consisted of multiple procedures carried out by a single surgeon, with several surgeons operating at a hospital and many hospitals across the country, which meant the data had a clustered structure with multiple levels. Dr Foster’s analysts chose to use a linear mixed effect model for this study.

Professor Philip Turner, Chair of the Orthopaedic Committee at the British Orthopaedic Association (BOA), said: “This study has added to the existing evidence that hospitals undertaking higher volumes of knee replacements achieve better outcomes for patients. This is an issue that the BOA is aware of and we are already working with our members and regional networks to consider the best ways of delivering care. Patients should be assured that across the UK, the standard of care for knee replacements is high and outcomes are good.”

Dr Foster’s chief executive Jason Harries said: “We hope that the findings of our latest study will have a positive impact on knee replacement surgery outcomes in the future. Granular analyses of this kind are hugely important in driving evidence-based improvements. The Dr Foster team will continue using its advanced analytical skills to examine the effects of provider and surgeon volume on various procedures and we look forward to publishing these in due course.”