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TUESDAY, April 19 (HealthDay News) -- Between 1991 and 2008, the length of stay (LOS) in the hospital for Medicare patients undergoing primary or revision hip arthroplasty decreased, while discharge to skilled care and readmission rates increased, according to a study published in the April 20 issue of the Journal of the American Medical Association.
Peter Cram, M.D., from the University of Iowa Carver College of Medicine in Iowa City, and colleagues investigated the demographics and outcomes of 1,453,493 Medicare part A beneficiaries who underwent primary total hip arthroplasty and 348,596 who underwent revision total hip arthroplasty. Changes in demographics, comorbidity, LOS in the hospital, mortality, discharge disposition, and all-cause readmission rates were measured between 1991 and 2008.
The researchers found that the average age and number of comorbid illnesses per patient for primary and revision total hip arthroplasty both increased significantly from 1991 to 2008. For primary hip arthroplasty, the average LOS decreased significantly from 9.1 days in 1991 to 1992 to 3.7 days in 2007 to 2008. Unadjusted in-hospital and 30-day mortality both decreased significantly, but 30-day all-cause readmission increased significantly in those undergoing primary hip arthroplasty. The proportion of primary total hip arthroplasty patients discharged home decreased, and those discharged to skilled care increased. Similar trends were seen for patients undergoing revision hip arthroplasty for all measures except 30-day mortality.
"Marked declines in hospital LOS for both primary and revision total hip arthroplasty seemed to correspond with an increase in the proportion of patients who were discharged to postacute care and an increase in patient readmissions," the authors write.
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