Patient Selection in Short Stay Total Hip Arthroplasty for Medicare Patients

Scott T Lovald; Kevin L Ong; Edmund C Lau; Girish P Joshi; Steven M Kurtz; Arthur L Malkani

doi:10.1016/j.arth.2015.05.040

Patient Selection in Short Stay Total Hip Arthroplasty for Medicare Patients

J Arthroplasty. 2015 Dec;30(12):2086-91. doi: 10.1016/j.arth.2015.05.040. Epub 2015 May 30.

Authors

Scott T Lovald¹, Kevin L Ong², Edmund C Lau¹, Girish P Joshi³, Steven M Kurtz², Arthur L Malkani⁴

Affiliations

¹ Exponent, Inc., Menlo Park, California.
² Exponent, Inc., Philadelphia, Pennsylvania.
³ Dept of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas, Texas.
⁴ University of Louisville, Dept. of Orthopaedic Surgery, KentuckyOne Health, Louisville, Kentucky.

PMID: 26115979
DOI: 10.1016/j.arth.2015.05.040

Abstract

There is a trend towards shortening inpatient hospital stays following total hip arthroplasty (THA) in an effort to reduce healthcare costs and potentially decrease complications. The purpose of this study was to identify patients who are at risk for readmission, complications, and mortality after short stay THA. The Medicare sample (1997-2011) was used to identify THA patients with 1-2-day (Group A, n=2949) or 3-day (Group B, n=8707) stays. Complication risks were similar between groups, though there was a reduced risk for hospitalization for Group A (adjusted hazard ratio=0.90, P=0.029). These findings suggest that age and comorbidities, particularly diabetes and cardiovascular conditions, have the greatest effect on readmission and event risk after short stay THA.

Keywords: complications; length of stay; readmission; short-stay; total hip arthroplasty.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Arthroplasty, Replacement, Hip*
Comorbidity
Female
Health Care Costs
Hospitalization / economics
Humans
Length of Stay*
Male
Medicare / statistics & numerical data
Patient Selection*
Proportional Hazards Models
United States