Study: Hip replacement hospital stays down, readmissions up

While Medicare beneficiaries who underwent hip replacement surgery between 1991 and 2008 were likely to have shorter hospital stays, they also were more likely to return to the hospital within 30 days or be discharged to skilled or intermediate care, according to a new study in the Journal of the American Medical Association.

Each year, about 280,000 total hip replacement surgeries are performed in the U.S. at the cost of more than $12 billion, the researchers said. The study, from the University of Iowa, was one of the first to analyze how hip replacement outcomes--and patient complexity--have changed over time, they added.

The average number of days that patients who had total hip replacements stayed in the hospital decreased about 60 percent from 9.1 days to 3.7 days, according to the study. At the same time, deaths from the surgery fell or remained stable from 1991 to 2008--even as sicker patients underwent the operation.

However, the researchers also found that the proportion of primary total hip arthroplasty patients discharged to home dropped from 68 percent in 1991-1992 to 48.2 percent in 2007-2008. Meanwhile, the proportion of patients discharged to skilled or intermediate care increased from 17.8 percent to 34.3 percent.

The 30-day all-cause readmission rate decreased from 5.9 percent in 1991-1992 to 4.6 percent in 2001-2002, but it began increasing to 8.5 percent in 2007-2008. Results were similar for 90-day readmission rates.

Researchers said the two findings are not likely coincidental. Readmissions and increased need for specialized care may be related to the shorter stay in hospitals after hip replacement, notes WebMD Health News.

For more details:
- view the JAMA abstract
- see the WebMD Health News article
- see the Bloomberg article