Patients who undergo total hip replacement surgery are spending less time in the hospital but more time in skilled-nursing facilities, according to results of a new study. And they're being readmitted to the hospital at a higher rate, researchers found.
Stay length falls, readmissions jump: study
Using Medicare data from nearly 1.5 million patients who underwent hip replacement surgery between 1991 and 2008, researchers analyzed a number of variables, including hospital length of stay, mortality and readmission rates. To reduce patients' length of stay—a common method of lowering costs—hospitals may, in many cases, discharge patients prematurely, according to the study, which appears in the April 20 issue of the Journal of the American Medical Association.
While the mean length of stay fell by roughly nine days during the study period, the proportion of patients discharged to their homes decreased to 48% from 68%. And the 30-day all-cause readmission rate spiked to 8.5% in 2007 and 2008, up from 5.9% in 1991 and 1992.
The results mirror a June 2010 study, which found shorter lengths of stay and higher readmission rates among heart failure patients.
“These findings reinforce the potential wisdom of moving to bundled payments, reimbursing for episodes of care, or a combination of both as a way for incentivizing the correct (length of stay), rather than perpetual reductions in LOS that seem to be occurring,” the authors wrote.
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