Pelt C et al. – This study determined whether lowering discharges to post–acute care centers (PACs) following total joint arthroplasty (TJA) by utilizing a step–by–step approach to create a comprehensive patient education, expectation, and management program would decrease readmissions and reoperations. The authors demonstrated that the program resulted in a reduction in the number of patients being discharged to PACs following TJA, along with a reduction in readmission and reoperations. Moreover, discharge to these facilities was found to be an independent risk factor for these complications.

Methods

• A total of 927 TJAs who underwent surgery 12 months before (n = 465) and after (n = 462) the multifaceted patient education and management program were retrospectively reviewed.

Results

• A 20% absolute reduction in discharges to PACs (<0.001) was reported.
• In patients who underwent TJA before implementation of the program, a greater frequency of 30–day readmissions (IRR 1.93) was reported.
• Prior to implementation, the risk for 90–day readmissions (IRR 1.70) and reoperations (IRR 1.67) was higher.
• A 2.4 and 3.10 times greater risk for 30–day readmissions and 30–day reoperations was associated with discharge to PACs.