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Post-acute discharge setting had weak association with hospital readmission rates after TJA
Recently published results showed post-acute discharge settings had a weak association with hospital readmission rates among patients with hip or knee joint replacements.
Researchers identified 605,417 patients who received elective total hip or knee replacements due to underlying osteoarthritis (OA) between 2009 and 2011 in an acute hospital and were discharged to an inpatient rehabilitation facility, a skilled nursing facility or home health care. Post-acute discharge setting and unplanned 30-day, 60-day and 90-day hospital readmissions were included as study outcomes. Researchers also built logistic regression models to compare the performance of the Charlson Comorbidity Index (CCI), the Elixhauser Comorbidity Index (ECI) and the CMS Hierarchical Condition Categories (CMS-HCC) using C-statistics.
Results showed unplanned hospital readmission rates of 5.3% at 30 days, 7.2% at 60 days and 8.5% at 90 days. Researchers noted 46.3% of patients were discharged to home health care vs. 40.9% to a skilled nursing facility and 12.7% to an inpatient rehabilitation facility. Researchers found a C-statistic for the base model in predicting post-acute discharge setting and 30-day, 60-day and 90-day readmission in total knee and hip replacement between 0.63 and 0.67, with a minimal increase in the C-statistic with the addition of the CCI, ECI and CMS-HCC. According to results, diabetes, pulmonary disease, arrhythmias and heart disease were most frequently associated with hospital readmissions. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.