Changes in Payment Regulation and Acute Care Use for Total Hip Replacement: Trends in Length of Stay, Costs, and Discharge, 1997–2012. Issue 2 (27th March 2015) - Cary, Michael P.
Abstract: Purpose: To describe trends in the length of stay (LOS), costs, mortality, and discharge destination among a national sample of total hip replacement (THR) patients between 1997 and 2012. Design: Longitudinal retrospective design Methods: Descriptive analysis of the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample data. Findings: A total of 3, 516, 636 procedures were performed over the study period. Most THR patients were women, and the proportion aged 44–65 years increased. LOS decreased from 5 to 3 days. Charges more than doubled, from $22, 184 to $53, 901. Deaths decreased from 43 to 12 deaths per 10, 000 patients. THR patients discharged to an institutional setting declined, while those discharged to the community increased. Conclusion: We found an increase in THR patients, who were younger, women, had private insurance, and among those discharged to community‐based settings. Clinical Relevance: Findings have implications for patient profiles, workplace environments, quality improvement, and educational preparation of nurses in acute and postacute settings.