Neighborhood socioeconomic disadvantages associated with prolonged length of stay and non-home discharge following revision total hip and knee joint arthroplasty.

Arthroplasty, replacement, hip Arthroplasty, replacement, knee Postoperative complications Social determinants of health Socioeconomic factors

Journal

Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469

Informations de publication

Date de publication:
May 2024
Historique:
received: 16 04 2024
accepted: 06 05 2024
pmc-release: 07 05 2025
medline: 20 5 2024
pubmed: 20 5 2024
entrez: 20 5 2024
Statut: epublish

Résumé

Discharge disposition and length of stay (LOS) are widely recognized markers of healthcare utilization patterns of total hip and knee joint arthroplasty (TJA). These markers are commonly associated with increased postoperative complications, patient dissatisfaction, and higher costs. Area deprivation index (ADI) has been validated as a composite metric of neighborhood-level disadvantage. This study aims to determine the potential association between ADI and discharge disposition or extended LOS following revision TJA. This study conducted a retrospective analysis of a consecutive series of revision hip and knee TJA patients from a single tertiary institution. Univariate and multivariate regression analysis was used to determine the association between ADI and discharge disposition or LOS, adjusting for patient demographics and comorbidities. 1047 consecutive revision TJA patients were identified across 463 different neighborhoods. 193 (18.4 %) had an extended LOS, and 334 (31.9 %) were discharged to non-home facilities. Compared with Q This study suggests that higher levels of neighborhood-level disadvantage may be associated with higher odds of non-home discharge and prolonged LOS following revision TJA. Development of interventions based on the area deprivation index may improve discharge planning and reduce unnecessary non-home discharges in patients living in areas of socioeconomic deprivation.

Sections du résumé

Background UNASSIGNED
Discharge disposition and length of stay (LOS) are widely recognized markers of healthcare utilization patterns of total hip and knee joint arthroplasty (TJA). These markers are commonly associated with increased postoperative complications, patient dissatisfaction, and higher costs. Area deprivation index (ADI) has been validated as a composite metric of neighborhood-level disadvantage. This study aims to determine the potential association between ADI and discharge disposition or extended LOS following revision TJA.
Methods UNASSIGNED
This study conducted a retrospective analysis of a consecutive series of revision hip and knee TJA patients from a single tertiary institution. Univariate and multivariate regression analysis was used to determine the association between ADI and discharge disposition or LOS, adjusting for patient demographics and comorbidities.
Results UNASSIGNED
1047 consecutive revision TJA patients were identified across 463 different neighborhoods. 193 (18.4 %) had an extended LOS, and 334 (31.9 %) were discharged to non-home facilities. Compared with Q
Conclusion UNASSIGNED
This study suggests that higher levels of neighborhood-level disadvantage may be associated with higher odds of non-home discharge and prolonged LOS following revision TJA. Development of interventions based on the area deprivation index may improve discharge planning and reduce unnecessary non-home discharges in patients living in areas of socioeconomic deprivation.

Identifiants

pubmed: 38766389
doi: 10.1016/j.jcot.2024.102428
pii: S0976-5662(24)00097-3
pmc: PMC11097079
doi:

Types de publication

Journal Article

Langues

eng

Pagination

102428

Informations de copyright

© 2024 Delhi Orthopedic Association. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Michelle Riyo Shimizu (MR)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Tony Lin-Wei Chen (T)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Anirudh Buddhiraju (A)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Blake Bacevich (B)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Ziwei Huang (Z)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Young-Min Kwon (YM)

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Classifications MeSH