Non-home discharge after total shoulder arthroplasty may be risk factor for readmission
Key takeaways:
- Non-home discharge may be an independent risk factor for readmission within 180 days after shoulder arthroplasty.
- Readmission rates were compared between patients discharged to post-acute care vs. home.
Published results showed patients discharged to a post-acute care facility after total shoulder arthroplasty may be at an increased risk for readmissions compared with patients discharged home.
Vivek N. Pandey, MS, a third-year medical student at the Medical University of South Carolina, and colleagues used the nationwide readmissions database to study data from 171,898 patients who underwent primary TSA between 2010 and 2020. Of these patients, 71% (n = 112,905) were discharged home without home health care; 21% (n = 35,506) were discharged home with home health care; and 8% (n = 13,487) were discharged to a post-acute care facility.
Compared with patients who had routine home discharge, patients discharged to post-acute care were more likely to be older, female, and have obesity, , a higher Charlson Comorbidity Index and Medicare insurance.
Pandey and colleagues found 180-day readmission rates were 18% for patients discharged to a post-acute care facility, 11% for patients discharged to home health care and 8.5% for patients who had routine home discharge.
“Although patients discharged to home health care had lower readmission rates than those discharged to a post-acute care facility, home health care readmission rates were still significantly higher when compared with routine home discharge,” Pandey and colleagues wrote in the study.
After binary logistic regression, they found discharge to a post-acute care facility was an independent predictor of readmission within 180 days (OR = 1.69).
“These findings underscore the need for careful discharge planning following TSA, as post-acute care facilities may not always be ideal for patient discharge,” Pandey and colleagues wrote. “Understanding risk factors that increase health care expenditures has significant utility for institutions in the era of bundled care,” they concluded.
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