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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Rozell, Joshua C. Courtney, Paul M. Dattilo, Jonathan R. Wu, Chia H. Lee, Gwo-Chin |
| Description | Author Affiliation: Rozell JC ( Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.); Courtney PM ( Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.); Dattilo JR ( Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.); Wu CH ( Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.); Lee GC ( Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.) |
| Abstract | BACKGROUND: Alternative payment models in total joint replacement incentivize cost effective health care delivery and reward reductions in length of stay (LOS), complications, and readmissions. If not adjusted for patient comorbidities, they may encourage restrictive access to health care. METHODS: We prospectively evaluated 802 consecutive primary total hip arthroplasty and total knee arthroplasty patients evaluating comorbidities associated with increased LOS and readmissions. RESULTS: During this 9-month period, 115 patients (14.3%) required hospitalization >3 days and 16 (1.99%) were readmitted within 90 days. Univariate analysis demonstrated that preoperative narcotic use, heart failure, stroke, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and liver disease were more likely to require hospitalization >3 days. In multivariate analysis, CKD and COPD were independent risk factors for LOS >3 days. A Charlson comorbidity index >5 points was associated with increased LOS and readmissions. CONCLUSION: Patients with CKD, COPD, and Charlson comorbidity index >5 points should not be included in alternative payment model for THA and TKA. |
| File Format | HTM / HTML |
| ISSN | 08835403 |
| Issue Number | 9 Suppl |
| Journal | The Journal of Arthroplasty |
| Volume Number | 31 |
| e-ISSN | 15328406 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2016-09-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine |
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