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. 2016 Mar-Apr;41(2):67-77.
doi: 10.1002/rnj.210. Epub 2015 Mar 27.

Changes in Payment Regulation and Acute Care Use for Total Hip Replacement: Trends in Length of Stay, Costs, and Discharge, 1997-2012

Michael P Cary Jr  1 , Marianne Baernholdt  2 , Elizabeth I Merwin  1
Affiliations

Changes in Payment Regulation and Acute Care Use for Total Hip Replacement: Trends in Length of Stay, Costs, and Discharge, 1997-2012

Michael P Cary Jr et al. Rehabil Nurs. 2016 Mar-Apr.

Abstract

Purpose: To describe trends in the length of stay (LOS), costs, mortality, and discharge destination among a national sample of total hip replacement (THR) patients between 1997 and 2012.

Design: Longitudinal retrospective design

Methods: Descriptive analysis of the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample data.

Findings: A total of 3,516,636 procedures were performed over the study period. Most THR patients were women, and the proportion aged 44-65 years increased. LOS decreased from 5 to 3 days. Charges more than doubled, from $22,184 to $53,901. Deaths decreased from 43 to 12 deaths per 10,000 patients. THR patients discharged to an institutional setting declined, while those discharged to the community increased.

Conclusion: We found an increase in THR patients, who were younger, women, had private insurance, and among those discharged to community-based settings.

Clinical relevance: Findings have implications for patient profiles, workplace environments, quality improvement, and educational preparation of nurses in acute and postacute settings.

Keywords: Utilization; outcomes; quality improvement; total hip replacement.

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Figures

Table 1
Table 1
Age group of THR patients while hospitalized between 1997 and 2012
Table 2
Table 2
Payer status for THR patients while hospitalized, between 1997 and 2012
Table 3
Table 3
Destination following hospital discharge for THR Patients, between 1997 and 2012
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