Preventing Hospital Readmissions and Limiting the Complications Associated With Total Joint Arthroplasty

Stephen Yu, Kevin L. Garvin, William L. Healy, Vincent D. Pellegrini, Richard Iorio

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Total joint arthroplasty is a highly successful surgical procedure for patients who have painful arthritic joints. The increasing prevalence of total joint arthroplasty is generating substantial expenditures in the American healthcare system. Healthcare payers, specifically the Centers for Medicare and Medicaid Services, currently target total joint arthroplasty as an area for healthcare cost-savings initiatives, which has resulted in increased scrutiny surrounding orthopaedic care, health resource utilization, and hospital readmissions. Identifying the complications associated with total hip and total knee arthroplasty that result in readmissions will be critically important for predictive modeling and to decrease the number of readmissions after total joint arthroplasty. In addition, improving perioperative optimization, providing seamless episodic care, and intensifying posthospital coordination of care may decrease the number of unnecessary hospital readmissions. Identified modifiable risk factors that substantially contribute to poor clinical outcomes after total joint arthroplasty include morbid obesity; poorly controlled diabetes and nutritional deficiencies; Staphylococcus aureus colonization; tobacco use; venous thromboembolic disease; cardiovascular disease; neurocognitive, psychological, and behavioral problems; and physical deconditioning and fall risk. Both clinical practice and research will be enhanced if defined total joint arthroplasty complications are standardized and stratification schemes are used to identify high-risk patients. Subsequently, clinical intervention will be warranted to address modifiable risk factors before proceeding with total joint arthroplasty.

Original languageEnglish (US)
Pages (from-to)199-210
Number of pages12
JournalInstructional course lectures
Volume65
StatePublished - Jan 1 2016

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Patient Readmission
Arthroplasty
Joints
Delivery of Health Care
Centers for Medicare and Medicaid Services (U.S.)
Knee Replacement Arthroplasties
Morbid Obesity
Cost Savings
Health Resources
Tobacco Use
Health Expenditures
Malnutrition
Health Care Costs
Arthritis
Orthopedics
Staphylococcus aureus
Hip
Cardiovascular Diseases
Psychology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Preventing Hospital Readmissions and Limiting the Complications Associated With Total Joint Arthroplasty. / Yu, Stephen; Garvin, Kevin L.; Healy, William L.; Pellegrini, Vincent D.; Iorio, Richard.

In: Instructional course lectures, Vol. 65, 01.01.2016, p. 199-210.

Research output: Contribution to journalArticle

Yu, Stephen ; Garvin, Kevin L. ; Healy, William L. ; Pellegrini, Vincent D. ; Iorio, Richard. / Preventing Hospital Readmissions and Limiting the Complications Associated With Total Joint Arthroplasty. In: Instructional course lectures. 2016 ; Vol. 65. pp. 199-210.
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