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Hospitalist co-management after TJA linked with more new diagnoses made during admission, higher costs
Although the use of hospitalist co-management model after total joint arthroplasty yielded shorter length of stays and more new diagnoses made during admission than a non-hospitalist model, the method led to more tests ordered postoperatively and total direct hospital costs with no significant difference in readmission.
Researchers retrospectively evaluated the records of 2,975 patients who underwent total joint arthroplasty. Investigators identified 1,319 patients who did not receive automatic hospitalist co-management postoperatively and 1,656 patients who did receive it.
Investigators compared the groups for American Society of Anesthesiologists classification, postoperative length of stay (LOS), readmission at 30 days, diagnoses present on admission, new diagnoses made at admission, tests needed postoperatively, discharge location and total direct costs.
Results showed the non-hospitalist group compared with the hospitalist group had more diagnoses present at admission. Investigators also noted the hospitalist group gained more new diagnoses during admission and had most tests ordered postoperatively compared with the non-hospitalist group. The hospitalist group also had a higher hospitalization cost and had an increased chance of being discharged to a skilled nursing facility.
According to researchers, patients in the hospitalist group had a lower LOS; however, evolving techniques for pain control and blood management may have influenced this outcome. Groups were not significantly different with regard to readmission. ‒ by Monica Jaramillo
Disclosures: Duplantier reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.