BACKGROUND:Cemented femoral fixation is considered the gold standard in hip arthroplasty for femoral neck fractures (FNFs), given lower periprosthetic fracture risk than cementless fixation. However, one major concern with cementation is bone-cement implantation syndrome (BCIS), a phenomenon involving cardiopulmonary distress attributed to cement pressurization. This study compared outcomes based on fixation method and stem design and evaluated the utilization of cemented versus cementless fixation following FNF. METHODS:A retrospective review identified 2,829 patients who underwent total hip arthroplasty or hemiarthroplasty for FNF between December 2017 and January 2024 within a multi-institutional hospital enterprise. Cementless fixation was performed in 598 patients (21%), who were younger (75 versus 83 years; P < 0.001) and more likely men (66 versus 56%; P < 0.001) than those who received cemented fixation. Patients were propensity-matched for age, sex, body mass index, and comorbidities to compare fixation type and stem design. Following propensity matching, 346 matched pairs were analyzed. Outcomes including BCIS, periprosthetic fracture, and mortality were compared using Fisher's exact tests and a conditional logistic regression model. RESULTS:Cemented fixation was associated with fewer periprosthetic fractures (4 versus 7%; P < 0.04) but more Grade 1 BCIS (43 versus 32%; P < 0.01). A separate propensity match was performed comparing collared cemented stems to metaphyseal filling and collared cementless implants, resulting in 213 matched pairs. There were no differences in BCIS (P < 0.56), periprosthetic fracture (3 versus 2%; P < 0.75), mortality (all P > 0.05), deep vein thrombosis, or surgical site infection between cohorts. CONCLUSIONS:Vital sign abnormalities consistent with BCIS, observed in both fixation cohorts, were primarily low-grade and clinically inconsequential. Surgeons should remain vigilant for the development of BCIS, but results from this study suggest that fears over morbidity and mortality due to cementation should not discourage the usage of cemented femoral fixation.

PURPOSE:To assess if hospitals with high physician employment differ in risk-standardized mortality and readmission rates. DESIGN/METHODOLOGY/APPROACH:A cross-sectional evaluation of data from the 2021 Hospital Readmission Reduction program, Hospital Value-Based Purchasing Program, American Hospital Association and Area Health Resource Files was utilized. A binary variable was created to identify hospitals with ≤ 50% or >50% employed physicians. Dependent variables included 30-day mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), pneumonia (PN), and chronic obstructive pulmonary disease (COPD) hospitalizations. Propensity score matching was utilized to compare hospitals. The final matched cohort compared 200 hospitals in each group ( ≤ 50% physicians and > 50% physicians). FINDINGS:After matching, hospitals with > 50% physician employment were associated with improved mortality scores for AMI (-0.36, 95% CI: -0.58, -0.14), COPD (-0.38, 95% CI: -0.63, -0.14), and PN (-0.71, 95% CI: -1.15, -0.27). No significant differences were noted for CHF mortality or readmission rates. ORIGINALITY/VALUE:There has been a growth in hospitals employing physician in the United States. This work demonstrates that hospitals with higher physician employment levels are associated with lower mortality scores. This likely reflects a broader organizational phenotype characterized by alignment, scale and clinical integration rather than physician employment as an isolated strategy. Further research should examine organizational features to better disentangle the structure and combination of organizational characteristics underlying these associations.

BACKGROUND:Hospitals' utilization of social determinants of health data represents an important strategy for improving patient outcomes and reducing 30-day readmissions. PURPOSE:Using a contingency theory lens, this study investigated the relationship between hospitals' use of social needs data (SND) and 30-day readmission rates for conditions targeted by the Centers for Medicare and Medicaid Services' Hospital Readmission Reduction Program. METHODOLOGY/APPROACH:A cross-sectional retrospective study was conducted using data from general and surgical acute care hospitals ( n =1,350). Regression models were used to examine associations between SND usage and 30-day readmission rates. FINDINGS:Hospitals using SND for referrals to social service organizations experienced a 0.46-point decrease in heart failure readmissions ( p <.001). Population health analytics use was associated with a 0.13-point decrease in hospital-wide readmissions ( p <.05). Complete utilization of SND use was associated with a 0.30-point decrease in COPD ( p <.05) and a 0.33-point decrease in pneumonia readmissions ( p <.05). CONCLUSIONS:The effectiveness of SND strategies varies significantly based on hospital characteristics, regional factors, and clinical conditions, supporting contingency theory's premise that performance depends on alignment between strategies and contextual factors. PRACTICE IMPLICATIONS:Rather than advocating for uniform activities, our results suggest that hospital administrators should seek to achieve an optimal fit between the social needs identified in their communities and their specific organizational and environmental circumstances.

Transitions from inpatient rehabilitation to home critically affect patient recovery and caregiver well-being. Social determinants of health (SDoH) shape these outcomes yet remain underexamined in rehabilitation settings. The objective of this study was to examine the prevalence of SDoH on patient and caregiver experiences during the first 30 days following discharge from a multi-site inpatient rehabilitation facility in the southeastern United States and explore patterns of patient satisfaction and caregiver burden that can influence care transitions. A prospective cross-sectional descriptive study surveyed 61 patients and 50 caregivers using validated instruments assessing SDoH, communication, discharge preparedness, and caregiver burden. Social isolation, affecting 18% of patients and 10% of caregivers, was the most prevalent challenge. Additional challenges include health literacy and transportation barriers. Caregivers experienced substantial burden: 60% decline in social activities, 50% decreased energy, and 40.9% negative physical health effects. However, 58.1% reported strengthened patient relationships. This study identifies the importance of care continuity and SDoHs after inpatient rehabilitation. Interdisciplinary interventions focused on these key challenges are essential for improving outcomes.

Robotic gastric bypass (RGB) continues to increase. However, conflicting data remain on its impact on patient-reported outcomes. We utilized the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) databases. Gastric bypass cases performed with laparoscopy (LGB) or robotic assistance (RGB) between 2015 and 2021 were analyzed. A 1:1 matched analysis compared outcomes between LGB and RGB performed at different time intervals (2015–2018 vs. 2091–2021). 286,531 RYGB cases (87

Background: Addressing social determinants of health in patient care helps hospitals better understand the non-medical factors influencing patients’ health outcomes. Objectives: The objective of this study was to evaluate the correlation between hospital characteristics, county determinants, and the systematic recording of health-related social needs among general and surgical acute care hospitals in the United States. It focused on the hospital’s routine collection of data on patients’ health-related social needs, such as transportation, housing, and food insecurity. Design: A cross-sectional retrospective study design was utilized. Methods: All hospitals that completed the American Hospital Association Annual survey (n = 2254) were included in the study. A series of multinomial logistic analyses were conducted. Results: The relative risk of hospitals routinely collecting health-related social needs data is 67% lower in for-profit hospitals and 90% higher in not-for-profit hospitals compared to government hospitals. Hospitals that are part of a system are 1.5 times more likely to routinely collect data on social needs. In addition, counties with higher household income have a statistically significant higher relative risk of hospitals collecting data on social needs, though the magnitude of the difference is small. The relative risk of hospitals collecting social needs data, but not routinely, is 2 times higher in teaching hospitals and 3 times higher among system hospitals. Conclusion: Our research strongly indicates that understanding and addressing these inherent hospital-related factors are essential for effectively integrating social determinants of health into routine healthcare data collection practices. Establishing more robust guidelines and standardization in these practices may enhance hospitals’ ability to document and utilize health-related social needs information, ultimately driving improved patient outcomes and supporting more equitable care.

The growth rate of robotic bariatric surgery has recently increased compared to prior years. The impact of this new growth rate on duodenal switch procedures (DSPs) remains uncertain. DSPs performed using robotic assistance (RDSPs) or conventional laparoscopy (LDSPs) were identified from the 2015 to 2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) databases. Then, 1:1 matched analysis compared outcomes between all RDSPs and LDSPs, and those performed during different operative periods (2015–2018 and 2019–2021). Then, 14,679 DSPs (73.6

This study aimed to explore contextual elements of the cancer experience that are consistently distressing and/or psychologically traumatic, as well as explore perceptions of Accelerated Resolution Therapy® (ART®) and its influence on the cancer experience. Using a qualitative descriptive design, semi-structured interviews were completed by 12 participants following the completion of ART. Interview data were analyzed using content analysis to identify major themes and patterns. Four themes included: (a) Cancer as the straw that broke the camel's back, (b) ART® is different from previous therapy, (c) Don't need to always be looking in the rearview mirror, and (d) Importance of early psychological intervention. Participants perceived that ART® was different and potentially more effective than other types of therapy they had previously received. Results support the diagnosis of cancer and the cumulative effects of previous life events and cancer-related stressors as traumatic events.

Obesity is an epidemic that affects individuals of all races. Literature reports reoperation rates from 0.1 to 6.5

INTRODUCTION:Venous thromboembolism (VTE) after urologic surgery occurs in approximately 1% of patients and is associated with perioperative morbidity and mortality. Given variability in thromboprophylaxis practice, we aim to analyze the utilization of Caprini risk-based thromboprophylaxis after prostatectomy and nephrectomy. METHODS:Cases were identified using the medical record from large tertiary care centers in the United States. Caprini score was calculated retrospectively. Prophylaxis was classified as either appropriate or inappropriate when comparing Caprini score recommendations with prophylaxis received. Bleeding was determined by International Classification of Diseases-10 diagnostic code, postoperative hemoglobin decrease of > 4 g/dL, or transfusion. Bivariate and multivariate regression analyses compared VTE and bleeding outcomes between prophylaxis cohorts. RESULTS:In the 6241 patients analyzed, inpatient, postoperative VTE rate was 0.72%. Appropriate inpatient prophylaxis was received by 36% of prostatectomy patients and 50% of nephrectomy patients. Less than 5% of patients in both cohorts received recommended appropriate discharge prophylaxis. Appropriate inpatient prophylaxis after prostatectomy resulted in an 8-fold significant reduction in inpatient VTE (0.07% vs 0.61%, P = .009) with an associated increased bleeding incidence (2.3% vs 0.98%, P < .001). The incidence of inpatient VTE after radical nephrectomy was 5.8-fold higher (1.7% vs 0.29%, P = .001) with inappropriate prophylaxis without a significant increased risk of bleeding. There was no significant difference in VTE rates or bleeding at 90 days postoperatively when stratifying by discharge prophylaxis in either cohort. CONCLUSIONS:For those identified as high risk by Caprini score, the benefits of inpatient VTE chemoprophylaxis must be balanced with bleeding risk after prostatectomy and nephrectomy.

BACKGROUND:Orthopaedic surgeons routinely delay surgical management of femoral neck fractures in patients taking direct oral anticoagulants (DOACs) to decrease perioperative bleeding and associated complications. However, this practice contradicts the principles of hip fracture management, as early surgery is associated with morbidity and mortality benefits. The purpose of this study was to quantify the association of DOAC use and perioperative outcomes in patients who underwent hemiarthroplasty (HA) or total hip arthroplasty (THA) for femoral neck fractures. We hypothesized that early surgical intervention on a patient taking a DOAC medication would not lead to worse perioperative outcomes. METHODS:A retrospective cohort study was conducted on 2,833 patients who underwent primary THA or HA for femoral neck fractures between December 31, 2017, and January 29, 2024, across our hospital system. The patients taking a DOAC were divided into 3 groups based on the time since the last DOAC intake: 1 day, 2 days, and ≥3 days. Propensity matching was performed 1:1, accounting for age, sex, Elixhauser Comorbidity Index, preoperative chronic kidney disease stage, preoperative hemoglobin, body mass index, and hospital type. Subanalyses utilizing linear and conditional logistic regression models were performed to assess differences in outcomes between the groups that had a DOAC withheld and the control groups. RESULTS:The mean age of all patients was 81 ± 10 years, 1,805 patients (64%) were women, and 207 patients (7%) were taking a DOAC prior to surgery. Despite comparable preoperative and postoperative hemoglobin levels between the groups that had a DOAC withheld and the control groups (all p > 0.05), the patients who had a DOAC withheld for 1 day were more likely to receive a postoperative blood transfusion (23.1% compared with 0%; p = 0.002). This difference in transfusion rate was not observed in other cohorts. There were no differences in medical complications, reoperation, discharge disposition, or mortality between the groups that had a DOAC withheld and the matched controls at any time point. CONCLUSIONS:Delaying surgical management due to DOAC medications may be unnecessary in patients undergoing arthroplasty for femoral neck fractures. Consideration should be given to adjusting transfusion triggers to reduce unwarranted blood transfusions in patients taking a DOAC. LEVEL OF EVIDENCE:Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

This study examined hospital-community partnership effects on 30-day readmission rates across 2,484 U.S. hospitals. Fixed effect linear models analyzed the impact of three partnership types across community strata. In average-to-low need communities, healthcare system partnerships reduced hospital-wide, heart failure, pneumonia, and THA/TKA readmissions, while local agency partnerships reduced hospital-wide, heart failure, and pneumonia rates. In high-need communities, all partnership types significantly decreased COPD and pneumonia readmissions, with community-based partnerships also reducing hospital-wide rates. Healthcare system partnerships showed the strongest effect on COPD reduction (β = -0.56, p < 0.001). These findings suggest partnerships may reduce readmissions, with stronger effects in high-need communities.

BackgroundDexamethasone (DEX) has been shown to reduce pain and postoperative nausea and vomiting for patients undergoing elective total joint arthroplasty (TJA). We investigated the impact of DEX on glycemic control and outcomes in patients with type 2 diabetes mellitus undergoing elective primary TJA.MethodsAll patients with type 2 diabetes mellitus undergoing primary elective TJA between January 2016 and December 2021 at 4 sites within 1 hospital system were identified. Propensity scores were calculated to match patients receiving or not receiving DEX. Primary outcomes were perioperative blood glucose levels and the incidence of hyperglycemia. Secondary outcomes were the amount of insulin administered, the occurrence of 30-day postoperative surgical site infections, hospital readmission, and mortality.ResultsAfter matching, we identified 1372 patients. DEX administration was associated with a significant increase in mean blood glucose levels in mg/dL on postoperative days (PODs) 0 to 2: POD 0 (28.4, 95% confidence interval [CI]: 24.6-32.1), POD 1 (14.4, 95% CI: 10.1-18.8), POD 2 (12.4, 95% CI: 7.5-17.2) when comparing patients who did or did not receive DEX. Additionally, patients receiving DEX, compared to patients who did not receive DEX, had increased odds of experiencing hyperglycemia on POD 0 (odds ratio: 4.0, 95% CI: 3.1-5.2). DEX was not associated with a significant difference in insulin administration, surgical site infections, hospital readmission, or mortality.ConclusionsIn our review of 1372 patients with propensity-matched type 2 diabetes mellitus undergoing elective, primary TJA, we found that DEX administration was associated with an increased risk of elevated mean glucose on POD 0-2, hyperglycemia on POD 0, but was not associated with an increase in total insulin dose administered nor occurrence of surgical site infections, hospital readmission, or mortality within 30 days of surgery in patients who received DEX compared to patients who did not receive DEX.Level of EvidenceIV.

GoalWhile studies have examined quality and health outcomes related to the Centers for Medicare & Medicaid Services' (CMS's) Hospital Value-Based Purchasing (HVBP) Program, a significant gap exists in the literature regarding the relationship between pay-for-performance initiatives and hospital financial performance in the program's Efficiency and Cost Reduction domain. This study examined the association between hospitals' cost inefficiency and participation in the HVBP Program by estimating the probability and magnitude of improvement or achievement in the program's Efficiency and Cost Reduction domain.MethodsThe 2014-2019 Efficiency and Cost Reduction domain data were obtained from CMS and merged with the American Hospital Association's Annual Survey Database. We conducted a zero-inflated negative binomial regression to account for the excessive number of zeros in the data.Principal FindingsThe negative binomial component of the model assessed the magnitude of the impact on the Efficiency and Cost Reduction improvement from each covariate, while the zero-inflated component assessed the odds of being in the "certain-zero" group, meaning no chance to improve or achieve. Hospital ownership, location, size, safety-net status, percentage of Medicare patients, and the number of registered nurses per bed were statistically significant. Additionally, the Herfindahl-Hirschman Index and teaching status significantly influenced efficiency performance.Practical ApplicationsChanges in hospital performance in this domain exist and have evolved. Hospitals might be at a disadvantage with this performance measure because of their inherent organizational structure. The HVBP Program may not provide clear enough direction or actionable incentive to address the needs of stakeholders influenced primarily by measures of Medicare spending per beneficiary. This study's findings hold practical value for policymakers, healthcare administrators, and researchers. Policymakers can use this information to tailor future pay-for-performance programs and effectively allocate resources. Healthcare administrators can identify areas for improvement and benchmark their performance against similar institutions. Researchers can explore the program's long-term sustainability and investigate cost drivers within different hospital groups. By understanding the link between hospital characteristics and cost reduction, all stakeholders can contribute to a more efficient healthcare system.

BackgroundManagement of periprosthetic fractures has been guided by the Vancouver classification, which recommends revision for fractures around a loose femoral implant (B2). New studies have challenged this approach, demonstrating acceptable outcomes with internal fixation. This study evaluates our experience with Vancouver B2 fractures, comparing internal fixation to femoral revision. We hypothesized that in select cases with cementless stems, internal fixation would provide acceptable results with reduced morbidity.MethodsA retrospective review was performed of periprosthetic hip fractures treated at our institution between 1 January 2012 and 4 November 2022. We excluded patients who did not have prior radiographs and evidence of stem subsidence, suggestive of a Vancouver B2 fracture. Thirteen patients were included in the analysis.ResultsFour patients (31%) underwent revision of the femoral component, 4 patients (31%) underwent plating, and 5 patients (38%) underwent internal fixation with cerclage cabling. The average operative duration was 158 minutes, 203 minutes, and 62 minutes for the revision, plating, and cabling cohorts, respectively (P = .009). Blood loss was 463 cc, 510 cc, and 90 cc for the revision, plating, and cabling cohorts, respectively (P = .036). Three patients in both the revision and plating cohorts each received a transfusion (75%), whereas no patients in the cabling cohort required a transfusion (P = .033). All patients demonstrated fracture healing on the postoperative radiographs. No patients required additional surgery during the follow-up period.ConclusionsWe have demonstrated that Vancouver B2 periprosthetic fractures with intact lateral cortices may be treated with internal fixation with cerclage cabling with excellent results.

BACKGROUND:Venous thromboembolism occurs in approximately 2% of patients undergoing abdominal and pelvic surgery for cancers of the colon, rectum, and anus and is considered preventable. The American Society of Colon and Rectal Surgeons recommends extended prophylaxis in high-risk patients, but there is low adherence to the guidelines. OBJECTIVE:This study aims to analyze the impact of venous thromboembolism risk-guided prophylaxis in patients undergoing elective abdominal and pelvic surgeries for colorectal and anal cancers from 2016 to 2021. DESIGN:This was a retrospective analysis. SETTING:The study was conducted at a multisite tertiary referral academic health care system. PATIENTS:Patients who underwent elective abdominal or pelvic surgery for colon, rectal, or anal cancer. MAIN OUTCOME MEASURES:Receipt of Caprini-guided venous thromboembolism prophylaxis, 90-day postoperative rate of deep vein thrombosis, pulmonary embolism, venous thromboembolism, and bleeding events. RESULTS:A total of 3504 patients underwent elective operations, of whom 2224 (63%) received appropriate thromboprophylaxis in the inpatient setting. In the postdischarged cohort of 2769 patients, only 2% received appropriate thromboprophylaxis and no thromboembolic events were observed. In the group receiving inappropriate thromboprophylaxis, at 90 days postdischarge, the deep vein thrombosis, pulmonary embolism, and venous thromboembolism rates were 0.60%, 0.40%, and 0.88%, respectively. Postoperative bleeding was not different between the 2 groups. LIMITATIONS:Limitations to our study include its retrospective nature, use of aggregated electronic medical records, and single health care system experience. CONCLUSION:Most patients in our health care system undergoing abdominal or pelvic surgery for cancers of the colon, rectum, and anus were discharged without appropriate Caprini-guided venous thromboembolism prophylaxis. Risk-guided prophylaxis was associated with decreased rates of inhospital and postdischarge venous thromboembolism without increased bleeding complications. See Video Abstract . MARGEN DE MEJORA EL IMPACTO DE LA TROMBOPROFILAXIS RECOMENDADA POR LAS DIRECTRICES EN PACIENTES SOMETIDOS A CIRUGA ABDOMINAL POR CNCER COLORRECTAL Y ANAL EN UN CENTRO DE REFERENCIA TERCIARIO:ANTECEDENTES:El tromboembolismo venoso ocurre en aproximadamente el 2% de los pacientes sometidos a cirugía abdominal y pélvica por cánceres de colon, recto y ano, y se considera prevenible. La Sociedad Estadounidense de Cirujanos de Colon y Recto recomienda una profilaxis prolongada en pacientes de alto riesgo, pero el cumplimiento de las directrices es bajo.OBJETIVO:Este estudio tiene como objetivo analizar el impacto de la profilaxis guiada por el riesgo de tromboembolismo venoso (TEV) en pacientes sometidos a cirugías abdominales y pélvicas electivas por cáncer colorrectal y anal entre 2016 y 2021.DISEÑO:Este fue un análisis retrospectivo.AJUSTE:El estudio se llevó a cabo en un sistema de salud académico de referencia terciaria de múltiples sitios.PACIENTES:Pacientes sometidos a cirugía abdominal o pélvica electiva por cáncer de colon, recto o ano.PRINCIPALES MEDIDAS DE RESULTADO:Recepción de profilaxis de tromboembolismo venoso guiada por Caprini, tasa postoperatoria de 90 días de trombosis venosa profunda, embolia pulmonar, tromboembolismo venoso y eventos de sangrado.RESULTADOS:Un total de 3.504 pacientes se sometieron a operaciones electivas, de los cuales 2.224 (63%) recibieron tromboprofilaxis adecuada en el ámbito hospitalario. En el cohorte de 2.769 pacientes después del alta, solo el 2% recibió tromboprofilaxis adecuada en la que no se observaron eventos tromboembólicos. En el grupo que recibió tromboprofilaxis inadecuada, a los 90 días después del alta, las tasas de trombosis venosa profunda, embolia pulmonar y tromboembolia venosa fueron del 0,60%, 0,40% y 0,88%, respectivamente. El sangrado posoperatorio no fue diferente entre los dos grupos.LIMITACIONES:Las limitaciones de nuestro estudio incluyen su naturaleza retrospectiva, el uso de registros médicos electrónicos agregados y la experiencia de un solo sistema de atención médica.CONCLUSIÓN:La mayoría de los pacientes en nuestro sistema de salud sometidos a cirugía abdominal o pélvica por cánceres de colon, recto y ano fueron dados de alta sin una profilaxis adecuada de TEV guiada por Caprini. La profilaxis guiada por el riesgo se asoció con menores tasas de tromboembolismo venoso hospitalario y dado de alta sin un aumento de las complicaciones de sangrado. (Traducción-Dr. Aurian Garcia Gonzalez ).

BackgroundWhile racial disparity in surgical mortality due to venous thromboembolism (VTE) has improved, a gap persists. Our study aim was to determine differences in VTE prevention practices and their impact on outcomes among racial surgical cohorts.MethodsElective surgeries performed between 1.1.2016-5.31.2021 were included. Racial/ethnic cohorts were propensity-matched 1:1 to non-Hispanic White (NHW) patients, and outcomes were compared using unadjusted logistic regression. Match cohort balance was assessed using absolute standardized mean differences and linear model analysis of variance (ANOVA). Pearson’s Chi-square tests evaluated bi-variate associations. Conditional logistic regression to compare outcomes between matched groups. Odds ratios, 95% confidence intervals, and p-values are reported. Analyses were performed using R version 4.1.2 and the R package Matchit.ResultsNon-Hispanic other race (NHOR) (vs. NHW) patients were less likely to receive inpatient prophylaxis (OR 0.86, CI:0.76-0.98). Appropriate prophylaxis resulted in similar VTE for NHB (p=0.71) and Hispanic (p=0.06), compared to NHW patients. Inpatient bleeding was higher in Hispanic patients with a higher likelihood of receiving appropriate prophylaxis (OR 1.94, CI:1.16-3.32) and NHOR patients with a lower likelihood (OR 1.90, CI:1.10-3.36)ConclusionPostoperative VTE was similar for minority patients receiving appropriate prophylaxis, compared to NHW patients. Inpatient bleeding was more likely in Hispanic and NHOR patients but may not be related to receiving appropriate prophylaxis. NHOR patients were less likely to receive inpatient thromboprophylaxis.

Introduction: Melanoma is a deadly type of skin cancer that develops from melanocytes and can manifest on the skin or other regions of the body. Its incidence is increasing rapidly, with approximately 100,000 diagnoses and 7000 deaths per year in the US alone. We conducted a cross-sectional study with the aim of determining an association between the cost of care for invasive melanoma and the specialty involved in the treatment to adequately guide future treatment. Methods: We analyzed data from 3817 patients (2013–2018) using the Florida inpatient/outpatient dataset, CMS cost reports, and the National Plan and Provider Enumeration System. Covariates included age, sex, race/ethnicity, insurance type, region, county rurality, the number of procedures, the comorbidity index, obesity, metastatic cancer presence, hospital size, and physician volume. Multivariable mixed linear regression was used to analyze the data, and the cost was adjusted to the 2019 USD. Results: Dermatology had the largest decrease in the overall and outpatient costs compared to general surgery, followed by plastic surgery. The inpatient costs for dermatology and plastic surgery were lower than those for general surgery, but not significantly so. Conclusions: The costs associated with surgical procedures may vary depending on the specialty of the physician treating the patient. Dermatology was associated with lower treatment costs for invasive melanoma compared to other specialties, indicating that physician specialty influences the cost of care.