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Text
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<a href="http://doi.org/10.1177/2151459321996169" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/2151459321996169</a>
Pages
2151459321996169
Volume
12
ISSN
2151-4585 2151-4593
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Update Year & Number
April 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Orthopaedics
NEOMED Student Publications
Department of General Surgery
Affiliated Hospital
Cleveland Clinic Akron General Hospital
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Title
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Prior admissions as a risk factor for readmission in patients surgically treated for femur fractures: Implications for a potential hip fracture bundle.
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Geriatric Orthopaedic Surgery & Rehabilitation
Date
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2021
1905-07
Subject
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bundled payments; hip fracture; prior admission; readmission; SHFFT
Creator
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Erlichman R; Kolodychuk N; Gabra JN; Dudipala H; Maxhimer B; DiNicola N; Elias JJ
Description
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INTRODUCTION: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. METHODS: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. RESULTS: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). DISCUSSION: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. CONCLUSIONS: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.
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<a href="http://doi.org/10.1177/2151459321996169" target="_blank" rel="noreferrer noopener">10.1177/2151459321996169</a>
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journalArticle
2021
April 2021 List
bundled payments
Cleveland Clinic Akron General Hospital
Department of General Surgery
Department of Orthopaedics
DiNicola N
Dudipala H
Elias JJ
Erlichman R
Gabra JN
Geriatric Orthopaedic Surgery & Rehabilitation
hip fracture
journalArticle
Kolodychuk N
Maxhimer B
NEOMED College of Medicine
NEOMED Student Publications
prior admission
readmission
SHFFT