Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement

To measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in pati...

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Autores: Burn, Edward|||0000-0002-9286-1128, Edwards, Christopher J., Murray, David W., Silman, Alan, Cooper, Cyrus|||0000-0003-3510-0709, Arden, N. K|||0000-0002-3452-3382, Pinedo-Villanueva, Rafael|||0000-0002-4723-5128, Prieto-Alhambra, Daniel|||0000-0002-3950-6346
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:188585
Acceso en línea:https://ddd.uab.cat/record/188585
https://dx.doi.org/urn:doi:10.1136/bmjopen-2017-019146
Access Level:acceso abierto
Palabra clave:Joint replacement
Knee arthroplasty
Hip arthroplasty
Length of stay
Costs
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spelling Trends and determinants of length of stay and hospital reimbursement following knee and hip replacementevidence from linked primary care and NHS hospital records from 1997 to 2014Burn, Edward|||0000-0002-9286-1128Edwards, Christopher J.Murray, David W.Silman, AlanCooper, Cyrus|||0000-0003-3510-0709Arden, N. K|||0000-0002-3452-3382Pinedo-Villanueva, Rafael|||0000-0002-4723-5128Prieto-Alhambra, Daniel|||0000-0002-3950-6346Joint replacementKnee arthroplastyHip arthroplastyLength of stayCostsTo measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles. Cross-sectional study using routinely collected data. National Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care. Study participants had a diagnosis of osteoarthritis or rheumatoid arthritis. Primary TKR, primary THR, revision TKR and revision THR. Length of stay and hospital reimbursement. 10 260 primary TKR, 10 961 primary THR, 505 revision TKR and 633 revision THR were included. Expected length of stay fell from 16.0 days (95% CI 14.9 to 17.2) in 1997 to 5.4 (5.2 to 5.6) in 2014 for primary TKR and from 14.4 (13.7 to 15.0) to 5.6 (5.4 to 5.8) for primary THR, leading to savings of £1537 and £1412, respectively. Length of stay fell from 29.8 (17.5 to 50.5) to 11.0 (8.3 to 14.6) for revision TKR and from 18.3 (11.6 to 28.9) to 12.5 (9.3 to 16.8) for revision THR, but no significant reduction in reimbursement was estimated. The estimated effect of year of surgery remained similar when patient characteristics were included. Length of stay for joint replacement fell substantially from 1997 to 2014. These reductions have translated into substantial savings. While patient characteristics affect length of stay and reimbursement, patient profiles have remained broadly stable over time. The observed reductions appear to be mostly explained by improved efficiency. 22018-01-0120182018-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/188585https://dx.doi.org/urn:doi:10.1136/bmjopen-2017-019146reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:1885852026-06-06T12:50:31Z
dc.title.none.fl_str_mv Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
evidence from linked primary care and NHS hospital records from 1997 to 2014
title Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
spellingShingle Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
Burn, Edward|||0000-0002-9286-1128
Joint replacement
Knee arthroplasty
Hip arthroplasty
Length of stay
Costs
title_short Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
title_full Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
title_fullStr Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
title_full_unstemmed Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
title_sort Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement
dc.creator.none.fl_str_mv Burn, Edward|||0000-0002-9286-1128
Edwards, Christopher J.
Murray, David W.
Silman, Alan
Cooper, Cyrus|||0000-0003-3510-0709
Arden, N. K|||0000-0002-3452-3382
Pinedo-Villanueva, Rafael|||0000-0002-4723-5128
Prieto-Alhambra, Daniel|||0000-0002-3950-6346
author Burn, Edward|||0000-0002-9286-1128
author_facet Burn, Edward|||0000-0002-9286-1128
Edwards, Christopher J.
Murray, David W.
Silman, Alan
Cooper, Cyrus|||0000-0003-3510-0709
Arden, N. K|||0000-0002-3452-3382
Pinedo-Villanueva, Rafael|||0000-0002-4723-5128
Prieto-Alhambra, Daniel|||0000-0002-3950-6346
author_role author
author2 Edwards, Christopher J.
Murray, David W.
Silman, Alan
Cooper, Cyrus|||0000-0003-3510-0709
Arden, N. K|||0000-0002-3452-3382
Pinedo-Villanueva, Rafael|||0000-0002-4723-5128
Prieto-Alhambra, Daniel|||0000-0002-3950-6346
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Joint replacement
Knee arthroplasty
Hip arthroplasty
Length of stay
Costs
topic Joint replacement
Knee arthroplasty
Hip arthroplasty
Length of stay
Costs
description To measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles. Cross-sectional study using routinely collected data. National Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care. Study participants had a diagnosis of osteoarthritis or rheumatoid arthritis. Primary TKR, primary THR, revision TKR and revision THR. Length of stay and hospital reimbursement. 10 260 primary TKR, 10 961 primary THR, 505 revision TKR and 633 revision THR were included. Expected length of stay fell from 16.0 days (95% CI 14.9 to 17.2) in 1997 to 5.4 (5.2 to 5.6) in 2014 for primary TKR and from 14.4 (13.7 to 15.0) to 5.6 (5.4 to 5.8) for primary THR, leading to savings of £1537 and £1412, respectively. Length of stay fell from 29.8 (17.5 to 50.5) to 11.0 (8.3 to 14.6) for revision TKR and from 18.3 (11.6 to 28.9) to 12.5 (9.3 to 16.8) for revision THR, but no significant reduction in reimbursement was estimated. The estimated effect of year of surgery remained similar when patient characteristics were included. Length of stay for joint replacement fell substantially from 1997 to 2014. These reductions have translated into substantial savings. While patient characteristics affect length of stay and reimbursement, patient profiles have remained broadly stable over time. The observed reductions appear to be mostly explained by improved efficiency.
publishDate 2018
dc.date.none.fl_str_mv 2
2018-01-01
2018
2018-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/188585
https://dx.doi.org/urn:doi:10.1136/bmjopen-2017-019146
url https://ddd.uab.cat/record/188585
https://dx.doi.org/urn:doi:10.1136/bmjopen-2017-019146
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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