Journal article
Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?
The Journal of arthroplasty, Vol.32(11), pp.3274-3285
Nov 2017
PMID: 28669571
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs.
The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA.
The year-to-year risk of 90-day readmission was reduced by 2% and 4% (P < .001) for THA and TKA, respectively. By contrast, the cost of readmissions did not change significantly over time. The 5 most important variables associated with the cost of 90-day THA readmissions (in rank order) were the nature of the readmission (ie, due to medical or procedure-related reasons), the length of stay, hospital's teaching status, discharge disposition, and hospital's overall total joint arthroplasty volume. The top 5 factors associated with the cost of 90-day TKA readmissions were (in rank order) the length of stay, hospital's teaching status, discharge disposition, patient's gender, and age.
Although readmission rates declined slightly, the results of this study do not support the hypothesis that readmission costs have decreased since the introduction of health care reform legislation. Instead, we found that clinical and hospital factors were among the most important cost drivers.
Metrics
7 Record Views
Details
- Title
- Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?
- Creators
- Steven M. Kurtz - Drexel UniversityEdmund C. Lau - ExponentKevin L. Ong - ExponentEdward M. Adler - New York University Langone Orthopedic HospitalFrank R. Kolisek - Indiana Orthopaedic HospitalMichael T. Manley - Stryker
- Publication Details
- The Journal of arthroplasty, Vol.32(11), pp.3274-3285
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Identifiers
- 991019167547904721
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Orthopedics