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Readmission rates for THA, TKA vs spinal procedures dropped after Hospital Readmissions Reduction Program
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After implementation of the Affordable Care Act, readmission rates for all surgical procedures decreased, according to recently published results. In addition, with implementation of the Hospital Readmissions Reduction Program, readmission rates for targeted procedures, such as total knee and total hip arthroplasty, decreased further.
In a retrospective cohort study, researchers identified 6,687,077 weighted hospitalizations for THA, TKA, lumbar spine fusion and laminectomy surgeries between Jan. 1, 2010 and Sept. 30, 2015. There were 4,765,566 hospitalizations for Hospital Readmissions Reduction Program-targeted conditions, which included THA and TKA, and 1,921,611 hospitalizations for non-targeted conditions, which included lumbar spine fusion and laminectomy. Investigators used logistic regression and interrupted time-series models to calculate and compare 30-day readmission trends with pre-implementation of the Hospital Readmissions Reduction Program (January 2010 to September 2012), implementation of the program (October 2012 to September 2014) and the penalty phase (October 2014 to September 2015).
Results showed risk-adjusted readmission rates after all procedures decreased similarly after passage of the ACA. Investigators noted that with the implementation of the Hospital Readmissions Reduction Program, there was a 0.018% per month decrease in the readmission rates after targeted procedures; however, this was not seen after non-targeted procedures. From 2010 to 2015, the weighted unadjusted 30-day readmission rates decreased 0.7% in patients with targeted conditions compared with a 0.1% decrease in patients with non-targeted conditions. Investigators found no correlation between penalties and a greater decrease in readmissions for either targeted or non-targeted procedures. – by Monica Jaramillo
Disclosures: Ramaswamy reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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Ramaswamy A, et al. JAMA Network Open. 2019;doi:10.1001/jamanetworkopen.2019.4634.
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