title: The effect of severity of disease on cost burden of 30-day readmissions following total joint arthroplasty (TJA).
abstract: In order to control the unsustainable rise in healthcare costs the Federal Government is experimenting with the bundled payment model for total joint arthroplasty (TJA). In this risk sharing model, providers are given one payment, which covers the costs of the TJA, as well as any additional medical costs related to the procedure for up to 90 days. The amount and severity of comorbid conditions strongly influence readmission rates and costs of readmissions in TJA patients. We identified 2026 TJA patients from our database with APR-DRG SOI data for use in this study. Both the costs of readmission and the readmission rate tended to increase as severity of illness increased. The readmission burden also increased as SOI increased, but increased most markedly in the extreme SOI patients.
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Kiridly
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: Alexa J
authors.initials: AJ
authors.lastname: Karkenny
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: Hutzler
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: James D
authors.initials: JD
authors.lastname: Slover
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: Richard
authors.initials: R
authors.lastname: Iorio
authors.affiliation: NYU Hospital for Joint Diseases.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Bosco
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D015897:Comorbidity; D003363:Cost Control; D017281:Cost of Illness; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D016344:Medicare Part A / Q000191:economics* / Q000639:trends; D010359:Patient Readmission / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics* / Q000639:trends; D012720:Severity of Illness Index; D014481:United States
keywords: 30day readmissions; cost burden; severity of disease; total joint arthroplasty