Rapid Discharge to Home After Total Knee Arthroplasty Is Safe in Eligible Medicare Patients

被引:28
作者
Klingenstein, Gregory G. [1 ]
Schoifet, Scott D. [1 ]
Jain, Rajesh K. [1 ]
Reid, Jeremy J. [1 ]
Porat, Manny D. [1 ]
Otegbeye, Mojisola K. [1 ]
机构
[1] Virtua Joint Replacement Inst, Reconstruct Orthoped, 200 Bowman Dr,Suite 100, Voorhees, NJ 08043 USA
关键词
total knee arthroplasty; healthcare policy; rapid recovery; early discharge; complications; TOTAL JOINT ARTHROPLASTY; TOTAL HIP; ENHANCED RECOVERY; RISK-FACTORS; COMPLICATIONS; MORTALITY; STAY; READMISSION; OUTCOMES; LENGTH;
D O I
10.1016/j.arth.2017.06.034
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
Background: This study was aimed at assessing the risk of readmission for Medicare patients discharged home within a day of total knee arthroplasty (TKA) compared to those discharged on day 2 or beyond in a community medical center. Methods: A hospital inpatient database was queried for all unilateral, primary TKAs performed on patients 65 years or older from January 1, 2013, to December 31, 2015. A total of 2287 patients met the study criteria, of which 1502 were discharged within a day (short stay), and 785 were discharged on day 2 or beyond (traditional stay). The main outcome measures were all-cause 30-day and unplanned 90-day readmissions. Results: Short-stay patients did not experience a higher 30-day readmission rate (1.1%) compared to the traditional-stay patients (2.7%), nor did they experience a higher rate of unplanned 90-day readmissions (1.7% vs 3.6%). The short-stay group had more favorable demographics compared to the traditional-stay group. Logistic regression results revealed that none of the demographic factors considered had a statistically significant impact on 30-day readmission odds for either group. For unplanned 90-day readmissions, the results showed that for the short-stay patients, with the exception of age, none of the other demographic factors had significant impact on readmission odds and none were significant for the traditional-stay group. Conclusion: Our results suggest that the Medicare patients meeting discharge criteria and discharged home within a day of TKA do not have an increased risk of 30-day and 90-day readmission. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:3308 / 3313
页数:6
相关论文
共 22 条
  • [21] Decreased Length of Stay After TKA Is Not Associated With Increased Readmission Rates in a National Medicare Sample
    Vorhies, John S.
    Wang, Yun
    Herndon, James H.
    Maloney, William J.
    Huddleston, James I.
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2012, 470 (01) : 166 - 171
  • [22] Unplanned Readmission After Total Joint Arthroplasty: Rates, Reasons, and Risk Factors
    Zmistowski, Benjamin
    Restrepo, Camilo
    Hess, Jordan
    Adibi, Darius
    Cangoz, Soltan
    Parvizi, Javad
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2013, 95A (20) : 1869 - 1876