Complications, Mortality, and Costs for Outpatient and Short-Stay Total Knee Arthroplasty Patients in Comparison to Standard-Stay Patients

Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes

“…The recent changes in healthcare insurance and the aging US population make the appropriate exploration of outpatient procedures in terms of safety and cost-effectiveness more important than ever. The large number of recent orthopaedic studies comparing inpatient and outpatient procedures underscores this importance [2,5,9,10,15,16,24,25,29,30,37,40,48].…”

“…The secondary aim was to assess if using different definitions of hospital stay, stated status versus actual LOS, would lead to different results when examining risk for postoperative adverse events after THA and TKA. The relevance of these research aims is important because not only is the number of these procedures expected to rise with an aging US population, but also because the number of studies investigating outpatient arthroplasty is expected to rise as a result of efforts to improve levels of patient satisfaction and reduce cost [15,26,29].…”

“…There has been a recent surge of interest in performing THA and TKA in the outpatient setting [3,4,9]. The benefits of outpatient arthroplasty are reported to include higher patient satisfaction and reduced costs [15,29]. Multiple studies comparing the outcomes of inpatient with outpatient arthroplasty have been reported [2,5,9,10,15,16,24,25,29,30,37,40,48].…”

“…This ''observation'' status obscures the division between what is considered inpatient or outpatient. Some studies on outpatient arthroplasty have defined ''outpatient'' status as patients who were discharged the same day [5,9,10], patients who stayed at most one night at the hospital [2,4,24], patients who stayed at most two nights at the hospital [15,25], or simply provided stated status with no quantitative description [16,29,40].…”

“…The annual demand for both THA and TKA in the United States is expected to increase substantially over the next decade owing to an aging population and increased public demand [26,29]. There has been a recent surge of interest in performing THA and TKA in the outpatient setting [3,4,9].…”