Preoperative risk factors for discharge to a postacute care facility after shoulder arthroplasty

Background Shoulder arthroplasty procedures are becoming increasingly prevalent in the United States due to expanding indications and an aging population. Most patients are discharged home, but a subset of patients is discharged to a postacute care (PAC) facility. The purpose of this study was to id...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2016-02, Vol.25 (2), p.201-206
Main Authors: Sivasundaram, Lakshmanan, BS, Heckmann, Nathanael, MD, Pannell, William C., MD, Alluri, Ram K., MD, Omid, Reza, MD, Hatch, George F. “Rick”, MD
Format: Article
Language:English
Subjects:
Age Factors
Aged
Arthroplasty, Replacement
Comorbidity
Databases, Factual
discharge
Female
Humans
Male
Medicare
nationwide
Orthopedics
Patient Discharge
rehabilitation
Residential Facilities - utilization
Risk Factors
Sex Factors
Shoulder arthroplasty
Shoulder Joint - surgery
United States - epidemiology
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Summary:Background Shoulder arthroplasty procedures are becoming increasingly prevalent in the United States due to expanding indications and an aging population. Most patients are discharged home, but a subset of patients is discharged to a postacute care (PAC) facility. The purpose of this study was to identify the risk factors for discharge to a PAC facility after shoulder arthroplasty. Methods The Nationwide Inpatient Sample discharge records from 2011 to 2012 were analyzed for patients who underwent a total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). Patient and hospital characteristics were identified. Univariate and multivariate analysis were used to determine the statistically significant risk factors for discharge to a PAC facility while controlling for covariates. Results In 2011 and 2012, 103,798 patients underwent shoulder arthroplasty procedures: 58,937 TSAs and 44,893 RTSAs were identified. RTSA patients were 1.3 times as likely to be discharged to a PAC facility as TSA patients ( P  = .001). Medicare patients were 2 times as likely to be discharged to a PAC facility than those with private insurance ( P  
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2015.07.028