Hospitals, surgeons may underestimate 30-day readmissions after TKR by 25%

LAS VEGAS — Research based on a survey of patients participating in the FORCE-TJR consortium indicates that hospitals and surgeons who care for total knee arthroplasty patients may underrate their 30-day readmission rates by 25%.

“In this sample of patients from varied practice settings across the United States, approximately one in four readmissions following total knee replacement occurred at an outside hospital,” David C. Ayers, MD, said. “Hospitals and surgeons may underestimate their readmission rates by 25% by looking only at readmissions to the hospital where the joint replacement occurred. Approaches such as direct-to-patient contact can assist in collecting this missing data.”

To evaluate the amount of “missing” readmission data that occurs when patients receive postoperative care at an outside hospital, Ayers and his colleagues analyzed the results of a 6-month postoperative survey by the FORCE-TJR consortium that asks patients whether they were readmitted to a hospital within 30 days of replacement, whether they were readmitted to the same surgical hospital or an outside hospital, and whether they were then treated for a surgical symptom or medical condition.

Ayers noted that the mean national instance of readmission for all Medicare patients during the study period was 5.6%. The mean FORCE Medicare patient readmission rate using CMS claims status was 4.7%. The mean FORCE self-reported readmission for patients was 6.6%.

“Readmissions to the joint replacement hospital was 75% of all readmissions, whereas readmissions to non-joint replacement hospitals was 25%,” he said. “When we looked at the joint replacement hospital, there were 37% [of admissions] that were readmitted for joint-specific reasons vs. 64% for medical reasons. A higher percentage of medical reasons were found at non-joint replacement hospitals (82%) vs. joint-specific reasons (17%). – by Gina Brockenbrough, MA

Reference:

Ayers DC, et al. Paper #480. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 23-28, 2015; Las Vegas.

Disclosure: Ayers reports no relevant financial disclosures.