TY - JOUR
T1 - Comparison of Short-Term Outcomes After Total Hip Arthroplasty Between an Orthopedic Specialty Hospital and General Hospital
AU - Padegimas, Eric M.
AU - Kreitz, Tyler M.
AU - Zmistowski, Benjamin M.
AU - Girden, Alexander J.
AU - Hozack, William J.
AU - Chen, Antonia F.
PY - 2017/8
Y1 - 2017/8
N2 - Background The purpose of this study is to compare perioperative outcomes for total hip arthroplasty (THA) at an orthopedic specialty hospital (OSH) and a general hospital (GH). Methods A retrospective study of all primary THAs was performed at an OSH and GH in 2014. A cohort of GH patients was manually matched to the OSH by clinical and demographic variables blinded to outcome. These matched groups were then unblinded and compared by length of stay (LOS), 90-day readmissions, mortality, reoperations, and inpatient rehabilitation utilization. Results The 329 THAs at the OSH were matched with 329 THAs at the GH. Average LOS for THA at the OSH was 1.10 ± 0.51 days compared with 1.27 ± 0.93 (P =.004) at the GH. There were 2 OSH readmissions vs 5 GH readmissions (P =.25). There were 3 OSH reoperations vs 4 GH reoperations (P =.70). There were no mortalities. Three OSH patients used inpatient rehabilitation vs 13 GH patients (P =.011). When GH outlier and rehabilitation patients were excluded, the difference in LOS was not significant (1.08 ± 0.47 vs 1.13 ± 0.55 days; t = 1.331; P =.184). Two OSH patients required transfer to a GH postoperatively (angina and gastrointestinal bleed). Conclusion This study found that perioperative outcomes for THA were equally good at the OSH and GH. Rehabilitation utilization was higher at the GH. The LOS at both facilities was lower than the national average of 2.9 days. When rehabilitation patients and outliers were excluded, there was no significant difference in LOS between the two.
AB - Background The purpose of this study is to compare perioperative outcomes for total hip arthroplasty (THA) at an orthopedic specialty hospital (OSH) and a general hospital (GH). Methods A retrospective study of all primary THAs was performed at an OSH and GH in 2014. A cohort of GH patients was manually matched to the OSH by clinical and demographic variables blinded to outcome. These matched groups were then unblinded and compared by length of stay (LOS), 90-day readmissions, mortality, reoperations, and inpatient rehabilitation utilization. Results The 329 THAs at the OSH were matched with 329 THAs at the GH. Average LOS for THA at the OSH was 1.10 ± 0.51 days compared with 1.27 ± 0.93 (P =.004) at the GH. There were 2 OSH readmissions vs 5 GH readmissions (P =.25). There were 3 OSH reoperations vs 4 GH reoperations (P =.70). There were no mortalities. Three OSH patients used inpatient rehabilitation vs 13 GH patients (P =.011). When GH outlier and rehabilitation patients were excluded, the difference in LOS was not significant (1.08 ± 0.47 vs 1.13 ± 0.55 days; t = 1.331; P =.184). Two OSH patients required transfer to a GH postoperatively (angina and gastrointestinal bleed). Conclusion This study found that perioperative outcomes for THA were equally good at the OSH and GH. Rehabilitation utilization was higher at the GH. The LOS at both facilities was lower than the national average of 2.9 days. When rehabilitation patients and outliers were excluded, there was no significant difference in LOS between the two.
KW - healthcare policy
KW - hospital readmission
KW - length of stay
KW - orthopedic specialty hospital
KW - outcomes analysis
KW - total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85018874185&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2017.03.032
DO - 10.1016/j.arth.2017.03.032
M3 - Article
C2 - 28449845
AN - SCOPUS:85018874185
VL - 32
SP - 2347
EP - 2352
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
IS - 8
ER -