Patient Expectation Is the Most Important Predictor of Discharge Destination After Primary Total Joint Arthroplasty

Halawi, Mohamad J.; Vovos, Tyler J.; Green, Cindy L.; Wellman, Samuel S.; Attarian, David E.; Bolognesi, Michael P.

doi:10.1016/j.arth.2014.10.031

Cited by 75 publications

(63 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding contradicts those of other published studies, mostly from the West, that reported that home-based care was more popular than an inpatient setting1–4,9–14,16–22,24,25) (Table 7). Such results demonstrate the current pattern of discharge disposition in South Korea, which does not seem to follow the Western pattern, probably as the bundled payment system has not been introduced yet in the country.…”

Section: Discussioncontrasting

confidence: 87%

“…Although the difference was remarkable, it did not reach statistical significance (p=0.057), probably because the complications were fewer over-all and the sample size was too small to decipher any difference. Although a prospective randomized study found no difference in the postoperative complication rate in the two discharge destinations4), most of the other studies from the Western world reported increased rates of early complications in patients discharged to an ECF as compared with those discharged to home3,14,16,17,19,24). The difference between our results and those of other studies could be because of the lower comorbidity profile of the patients discharged to ECFs in South Korea than that in Western countries.…”

Section: Discussionmentioning

confidence: 96%

“…Some of the various demographic and perioperative variables reported from the West to favor an inpatient facility as discharge destination after TKA include older age2,3,10,14,16,17, 20,21,24), female sex2,3,10,14,16,17,21), higher comorbidity index1,2,14,16,17,19,21), low socioeconomic status9,10), non-white race2,10), higher BMI16,17,21), longer operation time16,17), and longer length of stay in the acute-care hospital1,10–12,16,17,20,24). In our study, we did not find any difference in age and sex distribution between the two groups.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

Tiwari

Park

Lee

et al. 2018

Knee Surg Relat Res

View full text Add to dashboard Cite

PurposeTo compare extended care facility (ECF) and home as discharge destination after total knee arthroplasty (TKA) at a single high-volume tertiary center in South Korea.Materials and MethodsWe retrospectively analyzed 1,120 primary TKAs (614 patients) performed between January 2012 and December 2013. A telephonic survey was conducted to determine discharge destination. The data reviewed included demographic and surgical data, functional outcome at 2 years and complications within 3 months.ResultsECF and home received 316 patients (51%) and 298 patients (49%), respectively. The ECF group had more bilateral TKA patients than the home group (272 vs. 234; p=0.014) and more patients with additional hospital stay (44 vs. 22; p=0.009). A higher tendency of complications was seen at home (n=8, 2.7%) than the ECF (n=2, 0.6%) (p=0.057). No significant differences were found in any functional outcome measure. Home patients had better patient satisfaction than ECF patients (81.9% vs. 54.3%; p<0.001).ConclusionsPatients who returned home after discharge had similar functional outcome at 2 years after surgery and higher patient satisfaction than those in the ECF in spite of the higher tendency of complications. Patients need adequate counseling and education regarding advantages and limitations of the two discharge destinations.

show abstract

Section: Discussioncontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

Tiwari

Park

Lee

et al. 2018

Knee Surg Relat Res

View full text Add to dashboard Cite

show abstract

“…Following a multivariable analysis of 372 primary TJA patients, Halawi et al found that patient expectation of discharge destination was the most important predicator of final disposition following total joint arthroplasty [12]. The authors suggest that this represents an opportunity by providing better preoperative education to shape and manage patient expectations and promote a feeling of safety and readiness to discharge home by incorporating the determination of discharge destination in the preoperative clinic visit.…”

Section: Primary Tjamentioning

confidence: 99%

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

Tarity¹,

Swall²

2017

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Purpose of Review The purpose of this manuscript is to review published literature over the last 5 years to assess recent trends and influencing factors regarding discharge disposition and post-discharge care following total joint arthroplasty. We evaluated instruments proposed to predict a patient's discharge disposition and summarize reports investigating the safety in sending more patients home by reviewing complications and readmission rates. Recent Findings Current literature supports decreased length of hospital stay and increased discharge to home with cost savings and stable readmission rates. Summary Surgeons with defined clinical pathways and those who shape patient expectations may more effectively control costs than those without defined pathways. Further research is needed analyzing best practices in care coordination, managing patient expectations, and costeffective analysis of home discharge while at the same time ensuring patient outcomes are optimized following total joint arthroplasty.

show abstract

“…The participants frequently reported relying on assistance from friends and family and often noted appreciation for the reported assistance. It is not surprising that caregiver support at home has been identified as a significant predictor of discharge following hip and knee total joint arthroplasty, as well as an important part of recovery and transition to home (Churchill et al, 2018;Halawi et al, 2015). However, the level of support required after arthroplasty in general, let alone SA specifically, is a largely under researched topic.…”

Section: Implications For Future Researchmentioning

confidence: 99%

Patient Perceptions of Acute Phases of Rehabilitation Following Shoulder Arthroplasty

Stith¹,

Borrero²,

Santurri³

et al. 2020

The Open Journal of Occupational Therapy

View full text Add to dashboard Cite

Background: Shoulder arthroplasty is a common procedure, but a lack of research regarding recovery and rehabilitation limits occupational therapists from providing appropriate education and support. The purpose of this study was to explore and understand the patient's experiences in the acute recovery phase following shoulder arthroplasty.Method: Twelve participants completed three semi-structured interviews in the first 6 weeks following surgery. A basic-interpretive approach was used before coding interview transcriptions into categories.Results: The participants initially reported increased reliance on assistance and/or modifications in ADLs routines, such as dressing, bathing, and sleep. Interruption in sleep was reported because of pain and/or positioning restrictions, and frustration because of a lack of sleep and need for assistance was noteworthy. As sling usage decreased, the participants reported returning to ADLs with a coinciding reduction in frustration. Finally, the participants noted improvement in ADLs and IADLs and a return to tasks such as driving, cooking and meal preparation, and returning to social engagements. Overarching themes included presurgical expectations, advice, pain reduction, and general improvement in quality of life.Discussion: Changes to patient education, including ADLs and IADLs assistance needs, may improve patient recovery. Occupational therapists specifically may improve recovery by using their understanding of arthroplasty, environment, routines, and other factors that affect sleep. CommentsThe authors report the receipt of grants from the University of Indianapolis during the conduct of the study.

show abstract

Patient Expectation Is the Most Important Predictor of Discharge Destination After Primary Total Joint Arthroplasty

Cited by 75 publications

References 22 publications

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

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

Patient Perceptions of Acute Phases of Rehabilitation Following Shoulder Arthroplasty

Contact Info

Product

Resources

About