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Hospital Readmission in Total Hip Replacement Patients in 2009 and 2014

Published:February 04, 2018DOI:https://doi.org/10.1016/j.apmr.2017.12.031

      Highlights

      • Compared to 2009, overall rates of 30-day readmissions after total hip replacement (THR) decreased by 1.3% in 2014. The decrease in readmission rates varied by groups, with lesser improvements seen in THR patients who were younger, with private insurance, and residing in lower-income and rural communities.
      • Among all groups, only THR patients aged 18 to 44 years showed an increase (0.5%) in 30-day hospital readmission rates.
      • Device complications were the leading cause of readmission in THR patients, increasing from 19.8% in 2009 to 23.9% in 2014.

      Abstract

      Objective

      To document changes in 30-day hospital readmission rates and causes for returning to the hospital for care in THR patients.

      Design

      Retrospective cross-sectional descriptive design.

      Setting

      Community-based acute care hospitals.

      Participants

      Total sample size (N=142,022) included THR patients (identified as ICD-9-CM procedure code 81.51) in 2009 (n=31,232) and (n=32,863) in 2014.

      Interventions

      Not applicable.

      Main Outcome Measures

      30-Day hospital readmission.

      Results

      The overall readmission rate decreased by 1.3% from 2009 to 2014. The decrease in readmission rates varied by groups, with lesser improvements seen in THR patients who were younger, with private insurance, and residing in lower-income and rural communities. Device complications were the leading cause of readmission in THR patients, increasing from 19.8% in 2009 to 23.9% in 2014.

      Conclusions

      There has been little decrease in hospital 30-day readmission rates for US community hospitals between 2009 and 2014. Findings from this brief report indicate patient groups at greater risk for 30-day hospital readmission as well as leading causes for readmission in THR patients which can inform the development of tailored interventions for reduction.

      Keywords

      List of abbreviations:

      HCUP (Healthcare Cost and Utilization Project), HRRP (Hospital Readmissions Reduction Program), NRD (Nationwide Readmissions Database)
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