title: The Combined Influence of Sociodemographic, Preoperative Comorbid and Intraoperative Factors on Longer Length of Stay After Elective Primary Total Knee Arthroplasty.
abstract: This study assessed the collective association of sociodemographic, preoperative comorbid and intraoperative factors with longer length of stay (LOS) following elective primary total knee arthroplasty. Sociodemographic characteristics examined on 2638 adult cases included age, race/ethnicity, gender and socioeconomic status (SES). Intraoperative factors included operating time and anesthesia type. The collective associations of lower SES, female gender, advanced age, non-Caucasian race/ethnicity and certain comorbidities do present a synergistically elevated risk for longer LOS. In a value-driven healthcare environment, these findings further warrant the need for policymakers and payers to consider sociodemographic status when allocating resources to hospitals serving such patients.
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York; Department of Public Health, Faculty of Medicine, The University of Liverpool, Liverpool UK.
authors.forename: Ifeoma A
authors.initials: IA
authors.lastname: Inneh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D061646:Operative Time; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: SES; length of stay; primary TKA; socioeconomic status; value in healthcare; value-based care