703 posters,  63 sessions,  7 topics,  1978 authors 
ePostersLive® by SciGen® Technologies S.A. All rights reserved.

5546
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.

Rate

No votes yet

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

Introduction

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.

Objective

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.

Results

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)

Discussion

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.

Conclusions

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


Enter Poster ID (e.gGoNextPreviousCurrent