Home Recovery Lowers Hospital Return Post-Hip Surgery Compared to Nursing Facilities
Recent findings spotlight the link between recovery settings and hospital readmission rates following hip replacement procedures
By: Catie Hillard
November 8, 2023 – At the recent American Association of Hip and Knee Surgeons’ Annual Meeting in Grapevine, Texas, a striking contrast in postoperative outcomes emerged. The latest research showed patients rebounding from total hip arthroplasty (THA) in the comfort of their homes faced fewer hospital readmissions compared to those recuperating in skilled nursing facilities.
The short-term return to hospital statistics among a cohort of 13,000 individuals who underwent THA within a five-and-a-half-year window were analyzed for the study. The focus homed in on a comparison between two distinct post-discharge pathways: home health care, which accommodated the bulk of the study’s participants (11,000), and skilled nursing facilities, hosting 1,800 patients. The research team considered various factors including socioeconomic status, discharge details, length of hospital stay exceeding three days, the 6-Clicks score assessing physical function, and the presence of in-home caregiver support.
The differences observed were noteworthy. Patients funneled towards nursing facilities after their surgery showed significantly greater readmission rates. Diving deeper into demographics, those in skilled nursing facilities tended to be older, predominantly female, and more likely to rely on Medicare. Furthermore, this group also displayed a wider spectrum of prior medical conditions, a higher burden of comorbidities, greater socioeconomic challenges, and more intensive needs for caregiver support, coupled with lower physical function scores.
The numerical narrative paints a telling picture though. 30 days after surgery, the overall hospital readmission rate stood at 2.9%. Home health care recipients had a 2.3% rate of return, in stark contrast to the 6.9% for their counterparts in nursing facilities. Advancing to the 90-day mark, the rate for home-discharged patients was 4.9%, less than half of the 12.6% for those in nursing care.
When adjusting for a swath of variables — from functional and health status to living situations and insurance coverage — the data solidified. Recovery in a skilled nursing facility held a higher likelihood of hospital readmission within both the 30-day and 90-day intervals post-surgery.
This research underscores the significant impact that the setting of postoperative care has on the likelihood of returning to the hospital after hip surgery. Patients and healthcare providers may consider these findings when planning for postoperative recovery, as home-based recuperation not only promotes a more familiar and comfortable environment but may also lead to better short-term health outcomes.
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