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Home discharge has increased after total hip arthroplasty, however rates vary between large databases

Journal of Arthroplasty Aug 27, 2020

DeMik DE, Carender CN, Glass NA, et al. - This study was undertaken to investigate trends in discharge destination, length of stay (LOS), reoperations, and readmissions following total hip arthroplasty (THA). Researchers distinguished individuals undergoing primary THA applying ICD and CPT codes in the ACS NSQIP and Humana claims databases. They evaluated discharge destinations and classified them as home or not home. They evaluated trends in discharge destination, LOS, readmissions, reoperation, and comorbidity burden. In ACS NSQIP, a total of 155,637 patients were included who had undergone THA and the percentage of patients discharging home increased from 72.2% in 2011 to 87.0% in 2017. For both payers and hospitals, individuals undergoing THA more often discharged home and had shorter hospital LOS with lower readmission rates, despite an increasingly co-morbid patient population. It is likely these alterations in disposition and LOS have resulted in significant cost savings. The efforts necessary to maintain improvements should be recognized when changes to reimbursement are being assessed. This study's findings demonstrate that ACS NSQIP hospitals had a larger proportion of individuals discharged home and the source of data applied to benchmark hospitals should be considered as findings may differ.

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