Overall admission rates for orthopedic implantable medical devices (IMDs) were up substantially in 2009, compared to 2003, a new report by the U.S. General Accounting Office has found. Admission rate patterns for cardiac implantable medical devices were mixed.
Knee replacement rates grew 6.7 percent per year. Admission rates for dual-chamber pacemakers decreased steadily while rates for defibrillators and drug-coated stents increased through 2006 and generally declined thereafter, the GAO report found, in part reflecting a shift of surgeries to the outpatient setting.
Yet, an increase in admissions of patients in poorer health did not increase the average length of hospital stays. Average lengths of stay for orthopedic IMD patients decreased from 2003 through 2009, while the lengths of stay for cardiac IMD beneficiaries fell through 2007 but increased thereafter.
The GAO did the study because implantable medical devices are taking up a larger share of Medicare spending. In 2009, about 1.6 million IMD procedures were performed on Medicare beneficiaries – at a cost of about $20 billion.
Orthopedic and cardiac implantations—the most common IMD procedures provided to beneficiaries—accounted for nearly all IMD-related Medicare spending in that year, the GAO said.