title: Predictors of discharge to an inpatient extended care facility after total hip or knee arthroplasty.
abstract: Increased emphasis has been placed on hospital length of stay and discharge planning after total joint arthroplasty (TJA). The purpose of this study was to identify baseline patient characteristics that are predictive of discharge to an inpatient extended care facility (ECF) after TJA. Clinical, demographic, and resource utilization data were analyzed for 7818 consecutive patients who underwent primary or revision TJA at 1 of 3 high-volume TJA centers. A stepwise linear regression model was used to identify predictors of discharge to an ECF. Overall, 29% of patients were discharged to an ECF after TJA. Older age, higher American Society of Anesthesiologists class, Medicare insurance, and female sex were all associated with a higher likelihood of discharge to an ECF. Significant differences in practice patterns were found across hospitals with respect to discharge disposition after TJA. Further study is necessary to determine the appropriate criteria for discharge to an ECF after TJA.
authors.affiliation: Department of Orthopaedic Surgery and Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.forename: Amy
authors.initials: A
authors.lastname: Wagie
authors.forename: James M
authors.initials: JM
authors.lastname: Naessens
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
authors.forename: Harry E
authors.initials: HE
authors.lastname: Rubash
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011182:Postoperative Care / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*