Dataset Information
Association of Race/Ethnicity With Hospital Discharge Disposition After Elective Total Knee Arthroplasty.
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ABSTRACT: Importance
Total knee arthroplasty (TKA) is one of the most common elective procedures performed in adults with end-stage arthritis. Racial disparities in TKA outcomes have been described in the literature.Objectives
To assess the association of race/ethnicity with discharge disposition and hospital readmission after elective primary TKA and to assess the association of nonhome discharge disposition with hospital readmission risk.Design, setting, and participants
This retrospective cohort study used data from the Pennsylvania Health Care Cost Containment Council Database, a large regional database that included demographic data from all discharges of patients who underwent elective primary TKA in 170 nongovernmental acute care hospitals in Pennsylvania from April 1, 2012, to September 30, 2015. Data analyses were conducted from September 29, 2017, to November 29, 2017.Exposures
Patient race/ethnicity and discharge disposition.Main outcomes and measures
Discharge disposition and 90-day hospital readmission.Results
Among 107?768 patients, 7287 (6.8%) were African American, 68?372 (63.4%) were women, 46?420 (43.1%) were younger than 65 years, and 60?636 (56.3%) were insured by Medicare. In multivariable logistic regression, among patients younger than 65 years, African American patients were more likely than white patients to be discharged to inpatient rehabilitation facility (IRF) (adjusted relative risk ratio [aRRR], 2.49 [95% CI, 1.42-4.36]; P?=?.001) or a skilled nursing facility (SNF) (aRRR, 3.91 [95% CI, 2.17-7.06]; P?Conclusions and relevanceThis cohort study found that race/ethnicity was associated with higher odds of discharge to an IRF or SNF for postoperative care after primary TKA. Among patients younger than 65 years, African American patients were more likely than white patients to be readmitted to the hospital within 90 days. Discharge to an IRF or SNF for postoperative care and rehabilitation was also associated with a higher risk of readmission to an acute care hospital.
SUBMITTER: Singh JA
PROVIDER: S-EPMC6824220 | biostudies-literature | 2019 Oct
REPOSITORIES: biostudies-literature
Publications
Association of Race/Ethnicity With Hospital Discharge Disposition After Elective Total Knee Arthroplasty.
JAMA network open 20191002 10
<h4>Importance</h4>Total knee arthroplasty (TKA) is one of the most common elective procedures performed in adults with end-stage arthritis. Racial disparities in TKA outcomes have been described in the literature.<h4>Objectives</h4>To assess the association of race/ethnicity with discharge disposition and hospital readmission after elective primary TKA and to assess the association of nonhome discharge disposition with hospital readmission risk.<h4>Design, setting, and participants</h4>This ret ...[more]
