The purpose of this research is to evaluate clinical and cost effectiveness of\ntotal knee replacement surgery (TKA) for adults hospitalized in the United\nStates between 2010 and 2013. We tried to answer the question that whether\nlower length of stay and higher utilization of post-op facilities would be helpful\nto control the overall costs. Using the National Hospital Discharge Survey\n(NHDS) database and cost data from Blue Cross Blue shield, this study seeks\nto identify which U.S. region renders the highest quality patient care during a\nthree-year span of 2008-2010. Using length of stay and discharge disposition\n(2010) as input factors, and regional TKA costs (2013) as output factors, Data\nEnvelopment Analysis (DEA), a non-parametric method, illustrated the efficiency\nranking of four regions in the US on TKA expenditures. The result shows\nthe West is the most efficient region on controlling the overall cost by shrinking\nthe length of stay and increasing the utilization of short-term/long-term care\nfacilities.
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