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Large Joints Feature

Source: Wikimedia Commons and Erik Bjerkeso

Easy Fall Risk Score Predicts Post-TJA Readmission

Elizabeth Hofheinz, M.P.H., M.Ed. • Wed, July 26th, 2017

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Nothing like an unplanned readmission to throw a wrench into the bundled payment mix.

Now, researchers from Canada have established that an easy-to-use fall risk score can help facilitate appropriate discharge planning. The retrospective cohort study, “Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty,” was published in the July 2017 edition of the Journal of Arthroplasty.

Bheeshma Ravi, M.D., Ph.D. is a member of the Division of Orthopaedic Surgery at Sunnybrook Health Sciences Center in Toronto, Canada, and a coauthor on the study. Dr. Ravi commented to OTW, “It is important to be able to identify patients at increased risk for readmission as we can discharge plan more effectively (i.e., send to rehab or a skilled nursing facility instead of sending them home). This has been a timely topic for many years, but it is increasingly relevant for hospitals as we switch toward bundled payments. We used Medicare data which meant we could capture readmissions at other institutions.”

The authors wrote, “”Of 2437 eligible TJA [total joint arthroplasty] recipients, there were 226 (9.3%) patients who had a score ≥ 6. These patients were more likely to have an unplanned readmission, were more likely to have a length of stay >3 days (49.6% vs 36.6%), and were less likely to be sent home after discharge (20.8% vs 35.8%). The effect of a score ≥ 6 on readmission remained significant after controlling for age, paralysis, and the presence of a major psychiatric disorder.”

Dr. Ravi told OTW, “Increased fall risk score after surgery increases the likelihood of readmission following discharge. The fall risk score is easy to use and is very informative.”

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