A Comparison of Discharge Functional Status After Rehabilitation in Skilled Nursing, Home Health, and Medical Rehabilitation Settings for Patients After Lower-Extremity Joint Replacement Surgery

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

“…While length of hospital stay following TJA has decreased over time [4,5], a corresponding increase in discharge to acute rehabilitation and skilled nursing facilities has occurred. Annual inpatient rehabilitation services have been estimated to cost more than $3 billion following TJA [6,7]. Increased demand for TJA and a paradigm shift in discharge destination is presently juxtaposed with an evolving reimbursement landscape.…”

Comparison of outcome measures from different pathways following total knee arthroplasty

“…(5)(6)(7)(8)(9)(10)(11) Reasons for discharging patients to step-down care in CHs include insufficient function to return to home environment or workforce, lack of caregiver at home and inability to conduct rehabilitation at home, thus requiring extended supervision. However, there are no defined criteria for continued care in CHs, and the discharge destination depends on both surgeon and patient evaluations on a case-by-case basis.…”

Approaches to Delivery of Care at Home Following Elective Hip and Knee Joint Replacement Surgery

“…Barbieri (2009) could not conclude that clinical pathways in general were cost-effective due to the lack of studies analysing the cost of development of those pathways [1]. Other studies have also shown no significant difference between hospital and outpatient rehabilitation programmes following hip and knee arthroplasty thus showing the controversy in current literature [6] [9] [26].…”

“…In a comparative study of functional outcome following joint replacement in patients who received rehabilitation at home, outpatients or hospital, home rehabilitation was found to be the optimal setting for healthy, less dependent patients and offered a significant advantage in recovery of functional status [6]. Many authors also show an enhanced patient satisfaction mainly due to shorter inpatient stays resulting in an increased ability to cope following arthroplasty [13]- [15].…”

“…Mallinson et al (2011) have shown even higher prevalence for hip and knee replacement surgery in the United States [6]. The factors above have resulted in methods of cost saving strategies whilst maintaining high quality patient care.…”