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全髋关节或膝关节置换术后入住住院康复机构的出院预测因素。

Predictors of discharge to an inpatient extended care facility after total hip or knee arthroplasty.

作者信息

Bozic Kevin J, Wagie Amy, Naessens James M, Berry Daniel J, Rubash Harry E

机构信息

Department of Orthopaedic Surgery and Institute for Health Policy Studies, University of California, San Francisco, CA, USA.

出版信息

J Arthroplasty. 2006 Sep;21(6 Suppl 2):151-6. doi: 10.1016/j.arth.2006.04.015.

Abstract

Increased emphasis has been placed on hospital length of stay and discharge planning after total joint arthroplasty (TJA). The purpose of this study was to identify baseline patient characteristics that are predictive of discharge to an inpatient extended care facility (ECF) after TJA. Clinical, demographic, and resource utilization data were analyzed for 7818 consecutive patients who underwent primary or revision TJA at 1 of 3 high-volume TJA centers. A stepwise linear regression model was used to identify predictors of discharge to an ECF. Overall, 29% of patients were discharged to an ECF after TJA. Older age, higher American Society of Anesthesiologists class, Medicare insurance, and female sex were all associated with a higher likelihood of discharge to an ECF. Significant differences in practice patterns were found across hospitals with respect to discharge disposition after TJA. Further study is necessary to determine the appropriate criteria for discharge to an ECF after TJA.

摘要

全关节置换术(TJA)后,人们越来越重视住院时间和出院计划。本研究的目的是确定全关节置换术后预测患者入住住院康复护理机构(ECF)的基线特征。分析了在3家高容量全关节置换中心之一接受初次或翻修全关节置换术的7818例连续患者的临床、人口统计学和资源利用数据。采用逐步线性回归模型确定入住康复护理机构的预测因素。总体而言,29%的患者在全关节置换术后入住康复护理机构。年龄较大、美国麻醉医师协会分级较高、医疗保险以及女性与入住康复护理机构的可能性较高相关。不同医院在全关节置换术后出院处置方面的实践模式存在显著差异。有必要进一步研究以确定全关节置换术后入住康复护理机构的适当标准。

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