Does the Risk Assessment and Prediction Tool Predict Discharge Disposition After Joint Replacement?

Abstract

Background Payers of health services and policymakers place a major focus on cost containment in health care.

Rapid recovery following hip and knee arthroplasty using local infiltration analgesia: length of stay, rehabilitation protocol and cost savings

“…The Risk Assessment and Prediction Tool (RAPT), developed by Oldmeadow at Alfred Hospital in Victoria in 2001, is utilized to predict the discharge destination after joint replacement surgery and helps align the expectations of patients after surgery. The accuracy of RAPT has been validated . Patients with scores below 6 usually require inpatient rehabilitation, while those who have RAPT score above 6 will usually be discharged directly home, and those with a RAPT score greater than 9 are most likely to go home on day 1 after surgery.…”

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

“…Hansen et al used this tool to assess 3213 patients undergoing TJA from 2006 to 2011. They found predictive accuracy in 80% of THA patients and 77% of TKA patients [20].…”

Optimization of physical functioning of patients before and after total hip arthroplasty

“…67,68 Our studies provide tools for risk assessment and discharge planning. Although the recent literature recommends the use of the Risk Assessment and Prediction Tool (RAPT) together with medical factors and body mass index, 68,69 we concluded that simple performance-based measures are of additional value to these more conventional measures and tools for predicting recovery (Chapter 3) and hence optimal discharge timing and destination. Shorter LOS and less use of inpatient rehabilitation will reduce costs; total hospital costs for THA are about 10,000 euro in the Netherlands 70 and 1 day of inpatient rehabilitation costs about 250 euro and a 14-day stay about 3000 euro.…”

“…Although exercise programs have an important role in optimizing preoperative and postoperative functioning, their effectiveness is still limited. [24][25][26]68,69 Given the different barriers elderly individuals face in their recovery after THA, there are several gaps between the needs of elderly patients and current care pathways and research.…”

“…Most care pathways and physical therapy interventions seem to be based on one-size-fits-all principle: on average, all patients receive the same intervention. The randomized controlled trials (RCTs) included in systematic reviews of the effectiveness of perioperative exercises typically used standardized exercises, 25,68,69 even though older people often have multiple diseases and geriatric symptoms that affect their physical abilities. A more tailored functional exercise program may fit the individual needs of elder people better.…”