title: Correlation between physician specific discharge costs, LOS, and 30-day readmission rates: an analysis of 1,831 cases.
abstract: There is currently wide variation in the use and cost of post acute care following total joint arthroplasty. Additionally the optimum setting to which patients should be discharged after surgery is controversial. Discharge patterns following joint replacement vary widely between physicians at our institution, however, only weak correlations were found between the cost of discharge and length of stay or readmission rates. The inter-physician variance in discharge cost did not correlate to a difference in quality, as measured by length of stay and readmission rates, but does imply there is significant opportunity to modify physician discharge practices without impacting patient outcomes and the quality of care.
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Ramos
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Wang
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Raj J
authors.initials: RJ
authors.lastname: Karia
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: Hutzler
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Claudette M
authors.initials: CM
authors.lastname: Lajam
authors.affiliation: NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Bosco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007348:Insurance, Health / Q000191:economics; D007902:Length of Stay / Q000191:economics*; D008297:Male; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D010351:Patient Discharge / Q000191:economics*; D010359:Patient Readmission / Q000191:economics*; D010820:Physicians / Q000191:economics; D012189:Retrospective Studies; D014481:United States
keywords: cost; discharge patterns; length of stay; post acute care; readmissions; total joint replacement