A new study published in the Journal of Arthroplasty examined the variation in where patients are discharged after hip and knee surgery.
Study authors collected a representative sample of privately insured Americans who underwent total hip or total knee replacement procedures in 2009 or 2010 through MarketScan. They used a multivariate logistic regression to predict the odds of discharge to extended care facilities.
Patients in the Northeast were 2.5 times more likely to be discharged to an extended care facility than patients in the South. In addition to variation across geographies, the patient's insurance provider had an impact on where they were discharged.
Patients with fee-for-service insurance plans or beneficiaries of exclusive provider organizations were less likely to be discharged to extended care facilities than patients enrolled in health maintenance organizations or in preferred provider organizations with capitation.
"Region and private insurance plan arrangements are related to extended care use among THA and TKA patients," concluded the study authors. "Understanding regional variation in discharge disposition provides policy makers with important information as to where to focus new tests of hip and knee procedures such as same day arthroplasty."