Determinants of discharge destination following elective total hip replacement
Article first published online: 8 DEC 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis Care & Research
Volume 51, Issue 6, pages 1009–1017, 15 December 2004
How to Cite
Pablo, P. d., Losina, E., Phillips, C. B., Fossel, A. H., Mahomed, N., Lingard, E. A. and N. Katz, J. (2004), Determinants of discharge destination following elective total hip replacement. Arthritis & Rheumatism, 51: 1009–1017. doi: 10.1002/art.20818
- Issue published online: 8 DEC 2004
- Article first published online: 8 DEC 2004
- Manuscript Accepted: 24 APR 2004
- Manuscript Received: 22 SEP 2003
- NIH. Grant Numbers: P01-AR-47782, K24-AR-02123
- AHRQ. Grant Number: 1R01-HS-09775-01
- Clinical Science Grant from the Arthritis Foundation
- Total hip replacement;
- Discharge destination;
- Rehabilitation facilities
To identify the factors associated with discharge to an inpatient rehabilitation facility versus discharge directly to home after elective total hip replacement (THR).
Data were obtained from a medical record review and a cross-sectional survey of a population-based cohort of patients who received elective primary or revision THR in 1995. Postoperative functional status was measured as the ability to walk independently prior to discharge. A multivariate regression model was developed with discharge to an inpatient rehabilitation facility versus directly to home as the dependent variable. The model adjusted for demographic characteristics, socioeconomic features, and several preoperative and postoperative clinical factors.
We included 1,276 patients age 65–94 years in the analysis. Of these, 58% were discharged from the acute care hospital to a rehabilitation facility. The cohort had mean age of 73 years; 96% were white; 62% were female; 32% were living alone; 38% had an annual income less than $20,000; and 78% were unable to walk independently in the hospital before discharge. For primary THR patients, multivariate analysis showed a significant association between being discharged to a rehabilitation facility and being unable to walk at discharge, older age, obesity, and living alone. For revision THR patients, multivariate analysis also showed a significant association between being discharged to a rehabilitation facility and being unable to walk at discharge.
In a large population-based sample, postoperative functional status, age, obesity, and social support all influenced the discharge destination following elective THR.