Key result
Index hospital teaching status was not significantly associated with 90-day all-cause readmission after primary total hip arthroplasty among Medicare beneficiaries (OR 0.98; 95% CI 0.947-1.011).
Why the study?
Given the financial and clinical implications of readmissions after primary THA and potential expenditure variations, it was unclear how index hospital teaching status impacts 90-day readmissions.
Does index hospital teaching status affect the incidence of 90-day readmissions in Medicare beneficiaries after primary total hip arthroplasty?
Observational (n=433,959)
Yes
Does index hospital teaching status affect the incidence of 90-day readmissions in Medicare beneficiaries after primary total hip arthroplasty?
Hospital teaching status is not significantly associated with 90-day all-cause readmission rates after primary total hip arthroplasty in Medicare beneficiaries.
Answers are grounded in this paper and cite their sources.
Teaching status shows no link to 90-day THA readmissions in Medicare patients; leaves open unmeasured confounding in this observational analysis.
BACKGROUND: Given financial and clinical implications of readmissions after total hip arthroplasty (THA) and the potential for varied expenditures related to a hospital's teaching status, this study sought to characterize 90-day hospital readmission patterns and assess likelihood of readmission based on teaching designation of a Medicare beneficiaries' (MB's) index THA hospital. METHODS: Retrospective analysis of 2016-2018 Centers for Medicare and Medicaid Services-linked data identified primary THA hospitalizations and readmissions within 90 days. Hospitals were categorized as teaching or nonteaching (Council of Teaching Hospitals and Health Systems). Chi-squared analysis and Fisher exact test assessed differences between readmission hospitals and the index hospital teaching status. Multivariate logistic regression models estimated risk-adjusted probability of experiencing at least one 90-day readmission. RESULTS: Analysis identified 433,959 index THA admissions with an all-cause 90-day readmission rate of 9.12%. Most readmissions were to the same hospital regardless of index THA hospital teaching status (67.5% index teaching; 68.2% index nonteaching). Crossover in hospital teaching status from the index procedure to readmission location was more common for those with index THA at a teaching hospital (18.9%) than for MBs with index THA performed at a nonteaching hospital (6.2%). Controlling for patient characteristics, no significant relationship was found between 90-day readmission and index hospital teaching status (odds ratio 0.98, confidence interval 0.947-1.011). CONCLUSIONS: Overall, while certain patterns of readmission after the index THA were observed, after controlling for patient characters and comorbidities, there was no significant association between 90-day all-cause readmission and index hospital teaching status.
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Borsinger et al. (2021) conducted an observational in Primary total hip arthroplasty (n=433,959). Teaching hospital vs. Nonteaching hospital was evaluated on 90-day all-cause readmission (OR 0.98, 95% CI 0.947-1.011). Index hospital teaching status was not significantly associated with 90-day all-cause readmission after primary total hip arthroplasty among Medicare beneficiaries (OR 0.98; 95% CI 0.947-1.011).
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