title: Comprehensive program reduces hospital readmission rates after total joint arthroplasty.
abstract: Hospital readmissions are quality indicators of healthcare delivery. Our purpose is to examine the effect of a program designed to reduce readmissions after total joint replacement.  We initiated a comprehensive program with 4 goals: (1) outpatient workup of venous thromboembolism; (2) decrease surgical site infection; (3) early follow-up with primary care physicians; and (4) increase physician awareness of the financial and quality-related ramifications of unplanned readmissions. We then compared readmission rates before our initiative was instituted (2005-2006) to 3 years after implementation (2007-2009).  Readmission rates preintervention were 3.70 and 3.29 for total hip replacement (THR) and knee replacement (TKR), respectively. Postintervention rates fell to 1.78 and 1.98, respectively, representing a 47.2% reduction of readmission for THR and 39.8% for TKR (P<.05).  These results demonstrate the success of our program in reducing readmissions. This may result in reductions in healthcare costs and improvement in quality of care.
authors: NYU Hospital for Joint Diseases, New York, NY, USA.
authors: Charles J
authors: CJ
authors: Jordan
authors: Rachel Y
authors: RY
authors: Goldstein
authors: Ryan F
authors: RF
authors: Michels
authors: Lorraine
authors: L
authors: Hutzler
authors: James D
authors: JD
authors: Slover
authors: Joseph A
authors: JA
authors: Bosco
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data; D003266:Continuity of Patient Care; D006801:Humans; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data*; D011320:Primary Health Care; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control