Is a shortened length of stay and increased rate of discharge to home associated with a low readmission rate and cost-effectiveness after primary total.

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Is a shortened length of stay and increased rate of discharge to home associated with a low readmission rate and cost-effectiveness after primary total knee arthroplasty? Steven J. Barad, MD, Stephen M. Howell, MD, Joyce Tom, RHIA, CPHQ Arthroplasty Today Volume 4, Issue 1, Pages 107-112 (March 2018) DOI: 10.1016/j.artd.2015.08.003 Copyright © 2015 The Authors Terms and Conditions

Figure 1 Overlay plot shows the average length of hospital stay per year for the hospital in the present study, which is juxtaposed with the 5th, 50th, and 95th percentiles of the 540 (2009) to 700 (2014) comparative hospitals in the national database. From 2009 to 2014, the average length of hospital stay per year in the present study shortened 37% from 2.0 to 1.3 nights (P < .0001) and was shorter than the 5th percentile of the comparative hospitals in the national database. Different letters (A–E) show those years with a change in the average length of hospital stay per year (P < .05). Arthroplasty Today 2018 4, 107-112DOI: (10.1016/j.artd.2015.08.003) Copyright © 2015 The Authors Terms and Conditions

Figure 2 Overlay plot shows the rate of patients discharged home per year with home health or outpatient physical therapy for the hospital in the present study, which is juxtaposed to the 5th, 50th, and 95th percentiles of the comparative hospitals in the national database. The percentage of patients discharged home per year in the present study increased from 59% in 2009 to 99% in 2014 and was higher than the 95th percentile of the comparative hospitals in the national database from 2010 to 2014. For the hospital in the present study, a value of P < .05 shows consecutive years in which the distribution of patients discharged to rehabilitation facility, home with health care, and home with outpatient physical therapy changed significantly. Arthroplasty Today 2018 4, 107-112DOI: (10.1016/j.artd.2015.08.003) Copyright © 2015 The Authors Terms and Conditions

Figure 3 Overlay plot shows the all-cause rate of readmission within 30 days of discharge per year for each year for the hospital in the present study, which is juxtaposed to the 20th, 50th, and 95th percentiles of the comparative hospitals in the national database. The annual rate of readmission within 30 days in the present study of 1.3% in 2009 and 0.9% in 2014 did not change (P = .38), and the annual rate of readmission within 30 days was not >10 points above the 20th percentile of the comparative hospitals in the national database. Arthroplasty Today 2018 4, 107-112DOI: (10.1016/j.artd.2015.08.003) Copyright © 2015 The Authors Terms and Conditions