Disparities in Discharge Destination After Lower Extremity Joint Arthroplasty: Analysis of 7924 Patients in an Urban Setting

Inneh, Ifeoma A.; Clair, Andrew J.; Slover, James; Iorio, Richard

doi:10.1016/j.arth.2016.05.027

Cited by 79 publications

(60 citation statements)

References 22 publications

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“…Within the postdischarge costs, the cost associated with various discharge dispositions after primary THA has received limited attention [31,32], despite being a large portion of the overall bundle. The results of this study demonstrate a significant difference in the day-of-surgery and the entire episode-of-care (day of surgery + 90 days postoperative) costs between different discharge dispositions.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty

Sabeh

Rosas

Buller

et al. 2017

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty

Sabeh

Rosas

Buller

et al. 2017

The Journal of Arthroplasty

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“…Socioeconomic status also seems to influence post-discharge disposition. Inneh et al reported that low to middle household income is strongly associated with an increased discharge to an institution following lower extremity joint arthroplasty although the reasons are unclear but may relate to variance in support and resources available that would facilitate home discharge [18]. A retrospective study comparing 50 consecutive home discharge and 50 consecutive SNF discharge patients demonstrated slower preoperative timed get up and go test, lower EQ-5D, living alone, higher ASA physical classification, increased hospital length of stay, and increased post-operative pain on day 1 and day 2, and decreased distance walked on post-operative day 1 was associated with discharge to skilled nursing facilities [7].…”

Section: Primary Tjamentioning

confidence: 99%

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Tarity¹,

Swall²

2017

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this manuscript is to review published literature over the last 5 years to assess recent trends and influencing factors regarding discharge disposition and post-discharge care following total joint arthroplasty. We evaluated instruments proposed to predict a patient's discharge disposition and summarize reports investigating the safety in sending more patients home by reviewing complications and readmission rates. Recent Findings Current literature supports decreased length of hospital stay and increased discharge to home with cost savings and stable readmission rates. Summary Surgeons with defined clinical pathways and those who shape patient expectations may more effectively control costs than those without defined pathways. Further research is needed analyzing best practices in care coordination, managing patient expectations, and costeffective analysis of home discharge while at the same time ensuring patient outcomes are optimized following total joint arthroplasty.

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“…Some of the various demographic and perioperative variables reported from the West to favor an inpatient facility as discharge destination after TKA include older age2,3,10,14,16,17, 20,21,24), female sex2,3,10,14,16,17,21), higher comorbidity index1,2,14,16,17,19,21), low socioeconomic status9,10), non-white race2,10), higher BMI16,17,21), longer operation time16,17), and longer length of stay in the acute-care hospital1,10–12,16,17,20,24). In our study, we did not find any difference in age and sex distribution between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

Tiwari

Park

Lee

et al. 2018

Knee Surg Relat Res

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PurposeTo compare extended care facility (ECF) and home as discharge destination after total knee arthroplasty (TKA) at a single high-volume tertiary center in South Korea.Materials and MethodsWe retrospectively analyzed 1,120 primary TKAs (614 patients) performed between January 2012 and December 2013. A telephonic survey was conducted to determine discharge destination. The data reviewed included demographic and surgical data, functional outcome at 2 years and complications within 3 months.ResultsECF and home received 316 patients (51%) and 298 patients (49%), respectively. The ECF group had more bilateral TKA patients than the home group (272 vs. 234; p=0.014) and more patients with additional hospital stay (44 vs. 22; p=0.009). A higher tendency of complications was seen at home (n=8, 2.7%) than the ECF (n=2, 0.6%) (p=0.057). No significant differences were found in any functional outcome measure. Home patients had better patient satisfaction than ECF patients (81.9% vs. 54.3%; p<0.001).ConclusionsPatients who returned home after discharge had similar functional outcome at 2 years after surgery and higher patient satisfaction than those in the ECF in spite of the higher tendency of complications. Patients need adequate counseling and education regarding advantages and limitations of the two discharge destinations.

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Disparities in Discharge Destination After Lower Extremity Joint Arthroplasty: Analysis of 7924 Patients in an Urban Setting

Cited by 79 publications

References 22 publications

The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty

The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

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