Risk Factors, Causes, and the Economic Implications of Unplanned Readmissions Following Total Hip Arthroplasty

被引:68
作者
Clement, Rutledge Carter [1 ]
Derman, Peter B. [2 ]
Graham, Danielle S. [3 ]
Speck, Rebecca M. [4 ]
Flynn, David N. [4 ]
Levin, Lawrence Scott [5 ]
Fleisher, Lee A. [4 ]
机构
[1] Univ N Carolina, Dept Orthopaed Surg, Chapel Hill, NC 27514 USA
[2] Hosp Special Surg, Dept Orthopaed Surg, Chapel Hill, NC USA
[3] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA
[4] Univ Penn, Dept Anesthesiol & Crit Care, Philadelphia, PA 19104 USA
[5] Univ Penn, Dept Orthopaed Surg, Philadelphia, PA 19104 USA
关键词
total hip arthroplasty; unplanned readmission; risk factors; economic analysis;
D O I
10.1016/j.arth.2013.04.055
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
In order to identify risk factors for readmissions following total hip arthroplasty (THA) and the causes and financial implications of such readmissions, we analyzed clinical and administrative data on 1583 consecutive primary THAs performed at a single institution. The 30-day readmission rate was 6.51%. Increased age, length of stay, and body mass index were associated with significantly higher readmission rates. The most common re-admitting diagnoses were deep infection, pain, and hematoma. Average profit was lower for episodes of care with readmissions ($ 1548 vs. $ 2872, P = 0.028). If Medicare stops reimbursing for THA readmissions, the institution under review would sustain an average net loss of $ 11,494 for episodes of care with readmissions and would need to maintain readmission rates below 23.6% in order to remain profitable. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:7 / 10
页数:4
相关论文
共 10 条
[1]  
*AG HEALTHC RES QU, HCUPNET TOOL ID TRAC
[2]  
[Anonymous], READM RED PROGR
[3]   The Validity of Using Administrative Claims Data in Total Joint Arthroplasty Outcomes Research [J].
Bozic, Kevin J. ;
Chiu, Vanessa W. ;
Takemoto, Steven K. ;
Greenbaum, Jordan N. ;
Smith, Thomas M. ;
Jerabek, Seth A. ;
Berry, Daniel J. .
JOURNAL OF ARTHROPLASTY, 2010, 25 (06) :58-61
[4]   Clinical Characteristics and Outcomes of Medicare Patients Undergoing Total Hip Arthroplasty, 1991-2008 [J].
Cram, Peter ;
Lu, Xin ;
Kaboli, Peter J. ;
Vaughan-Sarrazin, Mary S. ;
Cai, Xueya ;
Wolf, Brian R. ;
Li, Yue .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2011, 305 (15) :1560-1567
[5]   Re-admission rates within 28 days of total hip replacement [J].
Cullen, C. ;
Johnson, D. S. ;
Cook, G. .
ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, 2006, 88 (05) :475-478
[6]   Interventions to Reduce 30-Day Rehospitalization: A Systematic Review [J].
Hansen, Luke O. ;
Young, Robert S. ;
Hinami, Keiki ;
Leung, Alicia ;
Williams, Mark V. .
ANNALS OF INTERNAL MEDICINE, 2011, 155 (08) :520-U94
[7]   Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030 [J].
Kurtz, Steven ;
Ong, Kevin ;
Lau, Edmund ;
Mowat, Fionna ;
Halpern, Michael .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2007, 89A (04) :780-785
[8]  
MedPAC, 2007, C RPOM GREAT EFF MED
[9]  
Thomson Reuters, 2010, PREP READM PAYM RED
[10]   Readmission and Length of Stay After Total Hip Arthroplasty in a National Medicare Sample [J].
Vorhies, John S. ;
Wang, Yun ;
Herndon, James ;
Maloney, Williaml ;
Huddleston, James I. .
JOURNAL OF ARTHROPLASTY, 2011, 26 (06) :119-123