title: The effect of discharge disposition on 30-day readmission rates after total joint arthroplasty.
abstract: Previous studies have demonstrated no significant difference in overall functional outcomes of patients discharged to a sub acute setting versus home with health services after total joint arthroplasty. These findings coupled with pressure to reduce health care costs and the implementation of a prospective payment system under Medicare have supported the use of home rehabilitation services and the trend towards earlier discharge after hospitalization. While the overall functional outcome of patients discharged to various settings has been studied, there is a relative dearth of investigation comparing postoperative complications and readmission rates between various discharge dispositions. Our study demonstrated patients discharged home with health services had a significantly lower 30 day readmission rate compared to those discharged to inpatient rehab facilities. Patients discharged to rehab facilities have a higher incidence of comorbidity and this association could be responsible for their higher rate of readmission.
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Ramos
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: Raj J
authors.initials: RJ
authors.lastname: Karia
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: Hutzler
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Brandt
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: James D
authors.initials: JD
authors.lastname: Slover
authors.affiliation: NYU Hospital for Joint Diseases, New York, New York.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Bosco
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D014481:United States
keywords: discharge disposition; healthcare costs; outcomes; readmission; total joint arthroplasty