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Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset

Purpose: Total hip arthroplasty (THA) is one of the fastest growing procedures. There is increasing evidence that social determinants of health influence health care utilization and outcomes after THA, including postoperative care. We sought to examine how race impacts discharge destination after el...

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Autores principales: Mehta, Bella, Singh, Jasvinder A., Ho, Kaylee, Parks, Michael, Nelson, Charles, D'Angelo, Debra, Ibrahim, Said A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6922058/
https://www.ncbi.nlm.nih.gov/pubmed/31872168
http://dx.doi.org/10.1089/heq.2019.0083
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author Mehta, Bella
Singh, Jasvinder A.
Ho, Kaylee
Parks, Michael
Nelson, Charles
D'Angelo, Debra
Ibrahim, Said A.
author_facet Mehta, Bella
Singh, Jasvinder A.
Ho, Kaylee
Parks, Michael
Nelson, Charles
D'Angelo, Debra
Ibrahim, Said A.
author_sort Mehta, Bella
collection PubMed
description Purpose: Total hip arthroplasty (THA) is one of the fastest growing procedures. There is increasing evidence that social determinants of health influence health care utilization and outcomes after THA, including postoperative care. We sought to examine how race impacts discharge destination after elective THA, and we assessed the impact of discharge destination on 90-day readmission to an acute care hospital. Methods: We conducted a retrospective study using data from the Pennsylvania Health Care Cost Containment Council Database. We included patients of African American (AA) or white race undergoing THA, discharge disposition (inpatient rehabilitation facility [IRF], skilled nursing facility [SNF], home health care (HHC), home), and 90-day readmission rates. Results: Our study included 93,493 primary elective THAs. Compared with whites, AAs were more likely to be discharged to an IRF or SNF or HHC than home after THA. In all age groups, discharge to an IRF, SNF, or HHC for postop care/rehab was associated with higher odds of 90-day readmission as compared with home. Conclusion: AA race was associated with higher odds of discharge to an institution (IRF/SNF) or HHC for post-THA care. Disposition to these were associated with significantly higher risk of 90-day readmission to acute care hospital compared with home.
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spelling pubmed-69220582019-12-23 Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset Mehta, Bella Singh, Jasvinder A. Ho, Kaylee Parks, Michael Nelson, Charles D'Angelo, Debra Ibrahim, Said A. Health Equity Original Research Purpose: Total hip arthroplasty (THA) is one of the fastest growing procedures. There is increasing evidence that social determinants of health influence health care utilization and outcomes after THA, including postoperative care. We sought to examine how race impacts discharge destination after elective THA, and we assessed the impact of discharge destination on 90-day readmission to an acute care hospital. Methods: We conducted a retrospective study using data from the Pennsylvania Health Care Cost Containment Council Database. We included patients of African American (AA) or white race undergoing THA, discharge disposition (inpatient rehabilitation facility [IRF], skilled nursing facility [SNF], home health care (HHC), home), and 90-day readmission rates. Results: Our study included 93,493 primary elective THAs. Compared with whites, AAs were more likely to be discharged to an IRF or SNF or HHC than home after THA. In all age groups, discharge to an IRF, SNF, or HHC for postop care/rehab was associated with higher odds of 90-day readmission as compared with home. Conclusion: AA race was associated with higher odds of discharge to an institution (IRF/SNF) or HHC for post-THA care. Disposition to these were associated with significantly higher risk of 90-day readmission to acute care hospital compared with home. Mary Ann Liebert, Inc., publishers 2019-12-16 /pmc/articles/PMC6922058/ /pubmed/31872168 http://dx.doi.org/10.1089/heq.2019.0083 Text en © Bella Mehta et al. 2019; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Mehta, Bella
Singh, Jasvinder A.
Ho, Kaylee
Parks, Michael
Nelson, Charles
D'Angelo, Debra
Ibrahim, Said A.
Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title_full Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title_fullStr Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title_full_unstemmed Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title_short Race, Discharge Disposition, and Readmissions After Elective Hip Replacement: Analysis of a Large Regional Dataset
title_sort race, discharge disposition, and readmissions after elective hip replacement: analysis of a large regional dataset
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6922058/
https://www.ncbi.nlm.nih.gov/pubmed/31872168
http://dx.doi.org/10.1089/heq.2019.0083
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