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全髋关节置换术后90天再入院的患者因素及相关费用。

Patient Factors and Cost Associated with 90-Day Readmission Following Total Hip Arthroplasty.

作者信息

Plate Johannes F, Brown Matthew L, Wohler Andrew D, Seyler Thorsten M, Lang Jason E

机构信息

Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.

Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.

出版信息

J Arthroplasty. 2016 Jan;31(1):49-52. doi: 10.1016/j.arth.2015.07.030. Epub 2015 Jul 21.

Abstract

This study sought to identify specific costs for 90-day readmissions following total hip arthroplasty in a bundled payment system. Hospital billing records revealed 139 readmissions (8.93%) in 1781 patients. Mean costs for surgical readmissions were greater (P=0.002) compared with medical reasons, but similar for Medicare/Medicaid and private payers (P=0.975). Costs for imaging, laboratory workup, medication and transfusions, and hospital cost correlated with increasing SOI (P<0.05). Patients transferred from outside hospitals or rehabilitation had higher hospital (P=0.006) and operating room costs (P=0.001) compared to patients admitted from ED or clinic. Hospitals that care for complex patients with Medicare/Medicaid may experience increased costs for unplanned 90-day readmissions highlighting considerations for payer mix.

摘要

本研究旨在确定在捆绑支付系统下全髋关节置换术后90天再入院的具体费用。医院账单记录显示,1781例患者中有139例再入院(8.93%)。手术再入院的平均费用高于因医疗原因再入院的费用(P=0.002),但医疗保险/医疗补助和私人支付者的费用相似(P=0.975)。影像学检查、实验室检查、药物和输血费用以及医院费用与病情严重度指数增加相关(P<0.05)。与从急诊科或诊所入院的患者相比,从外部医院或康复机构转来的患者住院费用(P=0.006)和手术室费用更高(P=0.001)。为医疗保险/医疗补助的复杂患者提供护理的医院,可能会因计划外的90天再入院而增加费用,这突出了对支付者组合的考虑。

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