Readmission and Length of Stay After Total Hip Arthroplasty in a National Medicare Sample

被引:94
作者
Vorhies, John S. [1 ]
Wang, Yun
Herndon, James [2 ]
Maloney, Williaml [1 ]
Huddleston, James I. [1 ]
机构
[1] Stanford Univ, Med Ctr, Dept Orthopaed Surg, Stanford, CA 94305 USA
[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Orthopaed Surg, Boston, MA USA
关键词
length of hospital stay; total hip arthroplasty; medicare;
D O I
10.1016/j.arth.2011.04.036
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
Evaluation of hospital readmissions after total hip arthroplasty may help improve patient safety and cost reduction. This study investigates the rates and reasons for readmission as well as length of hospital stay (LOS) for 1802 total hip arthroplasty patients from 2002 to 2007. Data were abstracted from the Medicare Patient Safety Monitoring System. The overall 30-day rate of readmission was 6.8%. There was no difference in readmission rate from 2002 to 2004 (7.1%) to 2005 to 2007 (6.3%) (odds ratio, 0.90; 95% confidence interval, 0.63-1.30; P = .58). The overall mean LOS was 4.2 +/- 2.2 days. There was a significant reduction in LOS from 2002 to 2004 (4.4 +/- 2.5 days) to 2005 to 2007 (3.8 +/- 1.7 days) (odds ratio, 1.28; 95% confidence interval, 1.25-1.31; P < .0001). The most common causes for readmission were cardiac related. A reduction in LOS was not associated with an increase in the rate of readmission in this sample. Efforts to optimize cardiac status before discharge may lead to lower rates of readmission in the future.
引用
收藏
页码:119 / 123
页数:5
相关论文
共 22 条
[1]   Local anesthetics after total knee arthroplasty: intraarticular or extraarticular administration? A randomized, double-blind, placebo-controlled study [J].
Andersen, Lasse O. ;
Kristensen, Billy B. ;
Husted, Henrik ;
Otte, Kristian S. ;
Kehlet, Henrik .
ACTA ORTHOPAEDICA, 2008, 79 (06) :800-805
[2]   Does Discharge Disposition After Primary Total Joint Arthroplasty Affect Readmission Rates? [J].
Bini, Stefano A. ;
Fithian, Donald C. ;
Paxton, Liz W. ;
Khatod, Monti X. ;
Inacio, Maria C. ;
Namba, Robert S. .
JOURNAL OF ARTHROPLASTY, 2010, 25 (01) :114-117
[3]  
CHANG RW, 1996, JAMA-J AM MED ASSOC, V275, P11
[4]   The influence of pre-operative factors on the length of in-patient stay following primary total hip replacement for osteoarthritis A MULTIVARIATE ANALYSIS OF 2302 PATIENTS [J].
Dall, G. F. ;
Ohly, N. E. ;
Ballantyne, J. A. ;
Brenkel, I. J. .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2009, 91B (04) :434-440
[5]  
EPPS CD, 2004, AORN J, V79, P5
[6]   Projected prevalence of US adults with self-reported doctor-diagnosed arthritis, 2005 to 2050 [J].
Fontaine, Kevin R. ;
Haaz, Steffany ;
Heo, Moonseong .
CLINICAL RHEUMATOLOGY, 2007, 26 (05) :772-774
[7]  
FOOTE J, 2009, ANN R COLL SURG ENGL, V91, P6
[8]   Decreasing length of stay after total joint arthroplasty: Effect on referrals to rehabilitation units [J].
Forrest, GP ;
Roque, JM ;
Dawodu, ST .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1999, 80 (02) :192-194
[9]   Are clinical and patient assessed outcomes affected by reducing length of hospital stay for total hip arthroplasty? [J].
Hayes, JH ;
Cleary, R ;
Gillespie, WJ ;
Pinder, IM ;
Sher, JL .
JOURNAL OF ARTHROPLASTY, 2000, 15 (04) :448-452
[10]  
HUNT D, 2002, ADV PATIENT SAFETY R, V2