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Shorter Hospital Stay After Hip Replacement Surgery

Researchers Say Shorter Hospital Stay Could Be Behind Increase in Hospital Readmission Rates After Hip Replacement

Hip Replacement Becoming More Common continued...

And though it has been assumed that increasing experience with total hip replacement procedures has resulted in improvements in patient outcomes, data to support this belief is limited, the authors say.

Study author Peter Cram, MD, MBA, of the University of Iowa, and colleagues suggest that statistics may indicate that reducing length of stay in hospitals after hip replacements might increase readmission rates and discharge of patients to non-home settings.

They also write that despite increasing patient complexity, unadjusted and adjusted mortality rates for primary total hip replacement procedures showed substantial improvement over time.

But the unadjusted revision total hip replacement mortality rate increased modestly, though this was “largely explained by increasing patient complexity,” the study says.

Shorter Hospital Stays: Implications

The finding of a “marked decrease” in hospital length of stay after hip replacement surgery may have policy implications, the authors write, adding that hospitals may be motivated to reduce length of stay for payment reasons.

“We found that the reduction in hospital [length of stay] in both primary and revision total hip [replacement] patients was accompanied by a significant increase in the proportion of patients discharged to post-acute care facilities” such as nursing homes and rehabilitation centers “and a significant reduction in the proportion of patients discharged directly home.”

Readmission rates have increased markedly in recent years, suggesting, among other things, that “perpetual reductions” in hospital lengths of stay seem to be occurring.

The study is published in the April 20 issue of the Journal of the American Medical Association.

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