Journal
JOURNAL OF ARTHROPLASTY
Volume 30, Issue 12, Pages 2057-2060Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2015.06.007
Keywords
total hip arthroplasty; total knee arthroplasty; risk reduction; hospital readmission; blood transfusion; length of stay
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We assessed whether sequential incorporation of initiatives to decrease postoperative surgical complications were similarly effective in reducing 30-day readmission rates following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Readmission rates following TKA decreased substantially (5.6% vs. 3.0%, P < 0.001), but readmissions following THA (4.0% vs. 3.4%, P = 0.41) were not significantly reduced. The greatest impact of the multimodal treatment approach was a reduction of surgically related TKA complications. Advanced medical disease, facility discharge status, and Medicare or Medicaid coverage contributed to the highest risk for 30-day readmission after THA. Risk models defining expected readmission rates should account for these factors to avoid penalizing hospitals that provide higher proportional care to Centers for Medicaid and Medicare Services (CMS) beneficiaries. (C) 2015 Elsevier Inc. All rights reserved.
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