Inpatient admission after total hip arthroplasty for Medicare patients: New model finds predictive factors

An article published in the Journal of Arthroplasty outlined a model that predicts inpatient admission for Medicare beneficiaries following total hip arthroplasty.

Medicare does not currently reimburse for total hip arthroplasty in the ASC setting, but the agency indicated may decide to remove total hip arthroplasty from the inpatient only list in the future. The new model can help healthcare providers identify candidates for outpatient surgery, researchers said.

Researchers used the American College of Surgeons National Surgical Quality Improvement Program database to identify primary total hip arthroplasty patients over 65 years old who had surgery between 2006 and 2015. A total of 30,587 inpatient total hip arthroplasty procedures were identified, as well as 17,024 outpatient procedures. The researchers selected inpatient stay as a primary outcome measure, defined as a stay longer than two days.

Heart failure, simultaneous bilateral total hip arthroplasty, female gender and dependent functional status were the greatest factors determining inpatient status.

"Our model enabled accurate and simple identification of the best candidates for inpatient admission after [total hip arthroplasty] in Medicare-aged patients. Given the increasing feasibility of outpatient [total hip arthroplasty] coupled with the likelihood of [total hip arthroplasty] being removed from the [CMS] inpatient-only list, this model provides a framework to guide discussion and decision-making for stakeholders," researchers concluded.

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