title: Patient vs provider characteristics impacting hospital lengths of stay after total knee or hip arthroplasty.
abstract: This study aims to identify whether patient-level or provider-level characteristics are most influential on a patient's length of stay in the acute care hospital. A data set containing a nationally representative sample of inpatient discharge abstracts was used. Multilevel linear regression models were used to evaluate the associations between patient-level and provider-level characteristics on patients' lengths of stay. The target population included 322,894 discharges with a primary procedure code for primary total knee arthroplasty and 193,553 discharges for total hip arthroplasty. The variables associated with the greatest increases in length of stay were a higher comorbidity level among patient level attributes (+17.4%) and low surgeon volume among provider-level characteristics (+18.8%). Provider-level characteristics, particularly provider volume, had a greater impact on length of stay.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Medicine, Wood Building WG-57, Case Western Reserve University, Cleveland, Ohio 44106-4945, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Styron
authors.forename: Siran M
authors.initials: SM
authors.lastname: Koroukian
authors.forename: Alison K
authors.initials: AK
authors.lastname: Klika
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000191:economics / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000191:economics / Q000706:statistics & numerical data; D055815:Young Adult