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Readmission diagnoses following total hip replacement in relationship to insurance payer status
Session: MP-02a
Thurs, April 19, 10:15-11:45 am
Shubert (Shubert Complex), 6th floor

Please note, medically challenging cases are removed three months after the meeting and scientific abstracts after three years.


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Readmission Diagnoses Following Total Hip Replacement in Relationship to Insurance Payer Status

HarmandeepSingh, MD, Robert S. White, MD, Noelle S. Arroyo, BA, Licia K. Gaber-Baylis, BA, and Zachary A. Turnbull, MD


Total hip replacements (THR) are the sixth most common surgical procedure performed in the United States [1]. 

Although THR provides marked improvement of quality of life for patients, it is not without risk. Hospital readmission rates for THR are estimated at between 4.0% to 10.9% [2]. 

Postsurgical readmissions are associated with other surgical quality measures including surgical mortality and Hospital Quality Alliance Surgical Care score [3]. 

Readmissions can be influenced by the overall quality of care received due to various socioeconomic factors.


To assess the association, if any, between present-on-admission (POA) diagnoses of the readmission stay and patient’s insurance status for 30-day and 90-day readmissions in adults undergoing THR.


From 2007-2011, 297,103 patients underwent a THR in California, Florida, and New York

274,851 patients were ages 18 and older with available primary insurance payer and readmission data.

The most common reasons for 30-day readmissions compared to private insurance:

wound infection (15.7% Private Insurance; 19.3% Uninsured)

atrial fibrillation (5.9% Private Insurance; 18.4% Medicare)

urinary tract infection (6.3% Private Insurance; 13.3% Medicare)

pneumonia (3.4% Private Insurance; 6.9% Medicare). 

The most common reasons for 90-day readmissions compared to private insurance:

atrial fibrillation (5.5% Private Insurance; 16.9% Medicare)

urinary tract infection (4.5% Private Insurance; 12.0% Medicare)

wound infection (9.3% Private Insurance; 12.1% Uninsured)

pneumonia (2.7% Private Insurance; 6.2% Medicare)


Common reasons for readmission, including wound infection, atrial fibrillation, UTI, and pneumonia, were present at higher rates in Medicare and/or uninsured patients when compared to private insurance patients. 

Previous literature has shown that infections are among the most common causes of readmission after THR [2]. 

The association of higher readmission rate due to specific POA diagnoses in patients with Medicare may be due to various socioeconomic factors, which can be a source of confounding. 

Future research should focus on further delineating and addressing socioeconomic disparities in readmission after THR.


This study showed that a patient’s insurance payer status impacts 30-day and 90-day readmission diagnoses after THR. 

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