Ong Kevin L, Lotke Paul A, Lau Edmund, Manley Michael T, Kurtz Steven M
Exponent, Inc., Philadelphia, Pennsylvania.
University of Pennsylvania, Hospital of the University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania.
J Arthroplasty. 2015 Jul;30(7):1121-6. doi: 10.1016/j.arth.2015.02.030. Epub 2015 Feb 28.
This study evaluated the trends in discharge patterns and the prevalence and cost of post-discharge PT. The 5% Medicare database (1997-2010) was used to identify 50,886 primary THA and 107,675 TKA patients. More than 50% of patients were discharged from hospital to an inpatient facility. There were an increase in discharges to skilled nursing units and a reduced rate to rehabilitation facilities. In contrast to hospital, surgeon reimbursement, and implant costs, the average annual PT cost per patient rose through the study period. Approximately 25% of PT costs were used on less common modalities. PT costs more than $648 million a year. With the increased pressure to control costs for primary TJA, these patterns may change unless PT effectiveness can be demonstrated.
本研究评估了出院模式的趋势以及出院后物理治疗(PT)的患病率和成本。使用5%的医疗保险数据库(1997 - 2010年)来识别50886例初次全髋关节置换术(THA)患者和107675例全膝关节置换术(TKA)患者。超过50%的患者从医院出院后前往住院机构。转入专业护理机构的出院人数增加,而转入康复机构的比例下降。与医院、外科医生报销费用和植入物成本不同,在研究期间,每位患者的平均年度物理治疗成本有所上升。约25%的物理治疗成本用于不太常见的治疗方式。每年物理治疗费用超过6.48亿美元。随着控制初次全关节置换术(TJA)成本的压力增加,除非能证明物理治疗的有效性,否则这些模式可能会改变。