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Hospital, Patient, and Clinical Factors Influence 30- and 90-Day Readmission After Primary Total Hip Arthroplasty
Journal article   Open access   Peer reviewed

Hospital, Patient, and Clinical Factors Influence 30- and 90-Day Readmission After Primary Total Hip Arthroplasty

Steven M. Kurtz, Edmund C. Lau, Kevin L. Ong, Edward M. Adler, Frank R. Kolisek and Michael T. Manley
The Journal of arthroplasty, v 31(10), pp 2130-2138
Oct 2016
DOI: https://doi.org/10.1016/j.arth.2016.03.041
PMID: 27129760
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.arth.2016.03.041View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

30 days 90 days complications Medicare readmission total hip arthroplasty
The purpose of this study was to analyze the hospital, clinical, and patient factors associated with inpatient readmission after total hip arthroplasty (THA) in the Medicare population and to understand the primary reasons for readmission. The Medicare 100% national hospital claims database was used to identify 442,333 older patients (65+) with a primary THA in 3730 hospitals between 2010 and 2013. A multilevel logistic regression analysis with a clustered data structure was used to investigate the risk of all-cause 30- and 90-day readmission, incorporating hospital, clinical, and patient factors. At 30 days, 5.8% (median) of the patients were readmitted, whereas at 90 days, 10.5% (median) were readmitted. Geographic census region, hospital procedure volume, and nonprofit ownership were the only significant hospital factors among those we studied. Overall, clinical factors explained more of the variation in readmission rates than general hospital factors. Use of a perioperative transfusion was associated with 14% greater risk, patients discharged to home had 28% lower risk, and surgeon volume and length of stay were also significant risk factors. The top 5 most frequently reported primary reasons for 30-day readmission in THA were procedure related: dislocation (5.9%), deep infection (5.1%), wound infection (4.8%), periprosthetic fracture (4.4%), or hematoma (3.4%). These findings support further optimization of the delivery of care—both intraoperative and postoperative—to reduce the broad variation in hospital readmissions.

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79 citations in Scopus

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#3 Good Health and Well-Being

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Industry collaboration
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Web of Science research areas
Orthopedics
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