Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement

Roman Trimba; Richard T. Laughlin; Anil Krishnamurthy; Joseph S. Ross; Justin P. Fox

doi:10.1016/j.arth.2015.10.019

Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement

Roman Trimba^*, Richard T. Laughlin, Anil Krishnamurthy, Joseph S. Ross, Justin P. Fox

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Background: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. Methods: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. Results: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Conclusion: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.

Original language	English
Pages (from-to)	573-578.e2
Journal	Journal of Arthroplasty
Volume	31
Issue number	3
DOIs	https://doi.org/10.1016/j.arth.2015.10.019
State	Published - 1 Mar 2016
Externally published	Yes

Keywords

Emergency department visits
Hospital readmission
Level III
Quality measurement
Retrospective cohort study
Total hip arthroplasty
Total knee arthroplasty

Access to Document

10.1016/j.arth.2015.10.019

Cite this

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title = "Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement",

abstract = "Background: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. Methods: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. Results: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader {"}readmission{"} measure, 246 (47.6%) hospitals would change perceived performance groups. Conclusion: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.",

keywords = "Emergency department visits, Hospital readmission, Level III, Quality measurement, Retrospective cohort study, Total hip arthroplasty, Total knee arthroplasty",

author = "Roman Trimba and Laughlin, {Richard T.} and Anil Krishnamurthy and Ross, {Joseph S.} and Fox, {Justin P.}",

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T2 - Implications for Quality Measurement

AU - Trimba, Roman

AU - Laughlin, Richard T.

AU - Krishnamurthy, Anil

AU - Ross, Joseph S.

AU - Fox, Justin P.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. Methods: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. Results: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Conclusion: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.

AB - Background: Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. Methods: We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. Results: The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Conclusion: Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization.

KW - Emergency department visits

KW - Hospital readmission

KW - Level III

KW - Quality measurement

KW - Retrospective cohort study

KW - Total hip arthroplasty

KW - Total knee arthroplasty

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