title: Prevalence and Costs of Rehabilitation and Physical Therapy After Primary TJA.
abstract: This study evaluated the trends in discharge patterns and the prevalence and cost of post-discharge PT. The 5% Medicare database (1997-2010) was used to identify 50,886 primary THA and 107,675 TKA patients. More than 50% of patients were discharged from hospital to an inpatient facility. There were an increase in discharges to skilled nursing units and a reduced rate to rehabilitation facilities. In contrast to hospital, surgeon reimbursement, and implant costs, the average annual PT cost per patient rose through the study period. Approximately 25% of PT costs were used on less common modalities. PT costs more than $648 million a year. With the increased pressure to control costs for primary TJA, these patterns may change unless PT effectiveness can be demonstrated.
authors.affiliation: Exponent, Inc., Philadelphia, Pennsylvania.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Ong
authors.affiliation: University of Pennsylvania, Hospital of the University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Lotke
authors.affiliation: Exponent, Inc., Menlo Park, California.
authors.forename: Edmund
authors.initials: E
authors.lastname: Lau
authors.affiliation: Homer Stryker Center for Orthopaedic Education and Research, Mahwah, New Jersey.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Manley
authors.affiliation: Exponent, Inc., Philadelphia, Pennsylvania.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kurtz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000191:economics*; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D007592:Joint Diseases / Q000191:economics / Q000534:rehabilitation / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D006278:Medicare / Q000191:economics*; D010351:Patient Discharge / Q000191:economics*; D026741:Physical Therapy Modalities / Q000191:economics*; D015995:Prevalence; D014481:United States
keywords: THA; TKA; cost; physical therapy; rehabilitation