Study finds disproportional rates of same-day discharge TJA, patients discharged home
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Despite increasing rates of same-day discharge for total joint arthroplasties in the United States, a recent study has revealed that the proportion of patients who are discharged directly home remains unchanged.
From 2011 to 2016, researchers from the department of orthopaedic surgery at the University Health Network in Toronto analyzed 190,694 TJA patients, 9.5% (n = 17,224) of whom underwent same-day discharge total joint arthroplasty (SDD TJA).
According to the study, the researchers reviewed the PearlDiver patient records database, performing chi square analysis to compare patient demographics and complications, stratified by discharge disposition.
Nationwide SDD TJA rates increased from 0.95% to 20.5% during the study period, “however, the annual proportion of patients discharged directly home remained unchanged (approximately 68%), with the remaining discharged directly to an alternate care facility, most commonly inpatient rehabilitation,” the researchers wrote in the abstract.
Patients who were not discharged directly home were older, had high comorbidity scores and increased complications, according to the study.
“Although SDD TJA is increasing in frequency on an annual basis, up to one-third of patients are not discharged directly home — a proportion that remains unchanged over time,” the researchers concluded. “Moving forward, it is imperative that large administrative databases examining SDD TJA account for discharge disposition; moreover, there is a need to better understand the practice of SDD to an alternate care facility, specifically regarding rationale, cost, and patient outcomes,” they wrote.
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