title: Readmission and length of stay after total hip arthroplasty in a national Medicare sample.
abstract: Evaluation of hospital readmissions after total hip arthroplasty may help improve patient safety and cost reduction. This study investigates the rates and reasons for readmission as well as length of hospital stay (LOS) for 1802 total hip arthroplasty patients from 2002 to 2007. Data were abstracted from the Medicare Patient Safety Monitoring System. The overall 30-day rate of readmission was 6.8%. There was no difference in readmission rate from 2002 to 2004 (7.1%) to 2005 to 2007 (6.3%) (odds ratio, 0.90; 95% confidence interval, 0.63-1.30; P = .58). The overall mean LOS was 4.2 ± 2.2 days. There was a significant reduction in LOS from 2002 to 2004 (4.4 ± 2.5 days) to 2005 to 2007 (3.8 ± 1.7 days) (odds ratio, 1.28; 95% confidence interval, 1.25-1.31; P < .0001). The most common causes for readmission were cardiac related. A reduction in LOS was not associated with an increase in the rate of readmission in this sample. Efforts to optimize cardiac status before discharge may lead to lower rates of readmission in the future.
authors: Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.
authors: John S
authors: JS
authors: Vorhies
authors: Yun
authors: Y
authors: Wang
authors: James
authors: J
authors: Herndon
authors: William J
authors: WJ
authors: Maloney
authors: James I
authors: JI
authors: Huddleston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States