A study by researchers at New York University’s Langone’s Hospital for Joint Diseases has identified common causes for hospital readmissions following total hip (THA) and knee arthroplasty(TKA).
The patients studied were part of the Bundled Payment for Care Initiative from the Centers for Medicare and Medicaid Services. This is a government pilot program where hospitals are paid for the quality of their procedures rather than for the quantity performed. The idea behind the program was that one way to measure quality would be by examining hospital readmission rates.
The researchers studied 721 patients who had been admitted to NYU’s Langone’s Hospital for Joint Diseases between January and December of 2013. They found that THA and TKA readmissions accounted for 54% and 44% of the readmissions. Surgical complications included infections, wound complications, bleeding, periprosthetic fractures, dislocations and post-surgical pain. The average cost of the readmissions for surgical complications was $36, 038 for a THA and $61, 049 for a TKA.
They also measured medical complications. These included gastrointestinal disease, pulmonary disease, gastro urinary, hematologic, cardiovascular, endocrine, syncope, rheumatologic and lumbago complications and an open ankle wound. The average cost of medical complications was $22, 775 for THA and $10, 283 for TKA patients.
Joseph Bosco, co-author of the study, is pleased that readmissions were as low as they were. “While some complications are unavoidable, ” he said, “we are proud of our low readmission rates at the Hospital for Joint Diseases and for identifying the causes of readmission. We hope to reduce our rates even further.”
