Featured Research

from universities, journals, and other organizations

Study finds decrease in length of hospital stay after hip replacement, but increase in readmissions

Date:
April 19, 2011
Source:
JAMA and Archives Journals
Summary:
An analysis of data from Medicare beneficiaries who underwent hip replacement or subsequent follow-up corrective surgery between 1991 and 2008 indicates that the length of hospital stay after surgery declined during this time period, as did the proportion of patients discharged home, while there was an increase in the rate of hospital readmissions and discharge to a skilled care facility.

An analysis of data from Medicare beneficiaries who underwent hip replacement or subsequent follow-up corrective surgery between 1991 and 2008 indicates that the length of hospital stay after surgery declined during this time period, as did the proportion of patients discharged home, while there was an increase in the rate of hospital readmissions and discharge to a skilled care facility, according to a study in the April 20 issue of JAMA.

"Total hip arthroplasty [replacement] is a safe and effective therapy for patients with advanced degenerative joint disease. In recent years, there has been a dramatic increase in performance of this procedure both in the United States and abroad. There is a general assumption that increasing experience with total hip arthroplasty has resulted in improvements in patient outcomes, as has been observed in other procedures, but rigorous empirical data documenting such improvement are limited. This lack of data are striking given that an estimated 280,000 total hip arthroplasty procedures are performed annually at a cost of more than $12 billion," according to background information in the article.

Peter Cram, M.D., M.B.A., of the University of Iowa Carver College of Medicine, Iowa City, and colleagues evaluated the long-term trends in the outcomes of Medicare beneficiaries undergoing primary and revision (follow-up corrective surgery) total hip arthroplasty and to explore whether reductions in hospital length of stay (LOS) might be associated with increased discharge of patients to postacute care settings, increased readmission rates, or a combination of both outcomes. The study included data from between 1991 and 2008 on 1,453,493 Medicare Part A beneficiaries who underwent primary total hip arthroplasty and 348,596 who underwent revision total hip arthroplasty.

For primary total hip arthroplasty comparing 1991-1992 and 2007-2008, average age increased from 74.1 years to 75.1 years, and obesity prevalence increased from 2.2 percent to 7.6 percent, respectively. For revision total hip arthroplasty during these time periods, average age increased from 75.8 years to 77.3 years and obesity prevalence increased from 1.4 percent to 4.7 percent, respectively. For primary total hip arthroplasty, average hospital LOS decreased from 9.1 days to 3.7 days. After adjustment for patient characteristics, risk-adjusted 30-day mortality over the study period decreased from 0.7 percent to 0.3 percent and 90-day mortality decreased from 1.3 percent to 0.7 percent.

The researchers also found that the proportion of primary total hip arthroplasty patients discharged to home decreased from 68 percent in 1991-1992 to 48.2 percent in 2007-2008, while the proportion of patients discharged to skilled or intermediate care increased from 17.8 percent to 34.3 percent. The 30-day all-cause readmission rate decreased from 5.9 percent in 1991-1992 to 4.6 percent in 2001-2002, before increasing to 8.5 percent in 2007-2008. Results were similar for 90-day readmission rates.

"For revision total hip arthroplasty, similar trends were observed in hospital LOS, in-hospital mortality, discharge disposition, and hospital readmission rates," the authors write.

"In an analysis of 1991-2008 Medicare administrative data, 3 trends were identified. First, we found that despite increasing patient complexity, both unadjusted and adjusted mortality for primary total hip arthroplasty showed substantial improvement over time. Conversely, our second finding was that for revision total hip arthroplasty, unadjusted mortality appeared to increase modestly but this increase was largely explained by increasing patient complexity. Third and most importantly, marked declines in hospital LOS for both primary and revision total hip arthroplasty seemed to correspond with an increase in the proportion of patients who were discharged to postacute care and an increase in patient readmissions."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Peter Cram, Xin Lu, Peter J. Kaboli, Mary S. Vaughan-Sarrazin, Xueya Cai, Brian R. Wolf, Yue Li. Clinical Characteristics and Outcomes of Medicare Patients Undergoing Total Hip Arthroplasty, 1991-2008. JAMA, 2011; 305 (15): 1560-1567 DOI: 10.1001/jama.2011.478

Cite This Page:

JAMA and Archives Journals. "Study finds decrease in length of hospital stay after hip replacement, but increase in readmissions." ScienceDaily. ScienceDaily, 19 April 2011. <www.sciencedaily.com/releases/2011/04/110419164205.htm>.
JAMA and Archives Journals. (2011, April 19). Study finds decrease in length of hospital stay after hip replacement, but increase in readmissions. ScienceDaily. Retrieved April 18, 2014 from www.sciencedaily.com/releases/2011/04/110419164205.htm
JAMA and Archives Journals. "Study finds decrease in length of hospital stay after hip replacement, but increase in readmissions." ScienceDaily. www.sciencedaily.com/releases/2011/04/110419164205.htm (accessed April 18, 2014).

Share This



More Health & Medicine News

Friday, April 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com
Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com
Is Apathy A Sign Of A Shrinking Brain?

Is Apathy A Sign Of A Shrinking Brain?

Newsy (Apr. 17, 2014) A recent study links apathetic feelings to a smaller brain. Researchers say the results indicate a need for apathy screening for at-risk seniors. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins