Discharge to skilled nursing facility led to higher readmission rates vs. home health care
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Key takeaways:
- Patients discharged to home health care after total hip arthroplasty had 90-day readmissions of 4.9% vs. 12.6% when sent to a skilled nursing facility.
- Patients had an overall 90-day readmission rate of 5.9%.
GRAPEVINE, Texas — Data presented at the American Association of Hip and Knee Surgeons Annual Meeting showed higher readmission rates among patients discharged to a skilled nursing facility vs. home health care after total hip arthroplasty.
Matthew E. Deren, MD, and colleagues assessed 30- and 90-day readmission rates among 13,000 patients who underwent THA between January 2017 and August 2022 and were discharged to either a skilled nursing facility (n=1,800) or home health care (n=11,000). Researchers collected area deprivation index (ADI), discharge status, prolonged length of stay greater than 3 days, the 6-Clicks score and the availability of caregivers at home.
“Looking at our cohort, not surprisingly, there are significant differences between the groups,” Deren said during his presentation.
According to Deren, patients discharged to a skilled nursing facility were significantly more likely to be older and be women. Additionally, they were more likely to have Medicare insurance, a prior diagnosis of something other than osteoarthritis, a higher Charlson Comorbidity Index, higher ADI scores, 24-hour caregiver assistance at home and lower 6-Clicks score.
At 30 days postoperatively, Deren said patients had an overall readmission rate of 2.9%, with a readmission rate of 2.3% among patients discharged to home health care vs. 6.9% among patients discharged to a skilled nursing facility. He added the overall readmission rate increased to 5.9% at 90 days postoperatively, with a readmission rate of 4.9% among patients discharged to home health care and 12.6% among patients discharged to a skilled nursing facility.
After adjusting for functional status, age, diagnosis, level of caregiver assistance at home, ADI, Charlson Comorbidity Index, living environment and insurance status, Deren and colleagues found patients discharged to a skilled nursing facility were more likely to be readmitted within 30 and 90 days compared with patients discharged to home health care.
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Pasqualini I, et al. Paper 15. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 2-5, 2023; Grapevine, Texas.
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