Patient Factors and Cost Associated with 90-Day Readmission Following Total Hip Arthroplasty

J Arthroplasty. 2016 Jan;31(1):49-52. doi: 10.1016/j.arth.2015.07.030. Epub 2015 Jul 21.


This study sought to identify specific costs for 90-day readmissions following total hip arthroplasty in a bundled payment system. Hospital billing records revealed 139 readmissions (8.93%) in 1781 patients. Mean costs for surgical readmissions were greater (P=0.002) compared with medical reasons, but similar for Medicare/Medicaid and private payers (P=0.975). Costs for imaging, laboratory workup, medication and transfusions, and hospital cost correlated with increasing SOI (P<0.05). Patients transferred from outside hospitals or rehabilitation had higher hospital (P=0.006) and operating room costs (P=0.001) compared to patients admitted from ED or clinic. Hospitals that care for complex patients with Medicare/Medicaid may experience increased costs for unplanned 90-day readmissions highlighting considerations for payer mix.

Keywords: Medicaid; Medicare; bundled payment; cost; readmission; severity of illness.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / economics*
  • Female
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / economics*
  • Postoperative Complications / economics*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Severity of Illness Index
  • United States / epidemiology