Prior admissions as a risk factor for readmission in patients surgically treated for femur fractures: Implications for a potential hip fracture bundle.

Title

Prior admissions as a risk factor for readmission in patients surgically treated for femur fractures: Implications for a potential hip fracture bundle.

Creator

Erlichman R; Kolodychuk N; Gabra JN; Dudipala H; Maxhimer B; DiNicola N; Elias JJ

Publisher

Geriatric Orthopaedic Surgery & Rehabilitation

Date

2021
1905-07

Description

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.

Subject

bundled payments; hip fracture; prior admission; readmission; SHFFT

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

2151459321996169

Volume

12

ISSN

2151-4585 2151-4593

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Orthopaedics
NEOMED Student Publications
Department of General Surgery

Update Year & Number

April 2021 List

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

Erlichman R; Kolodychuk N; Gabra JN; Dudipala H; Maxhimer B; DiNicola N; Elias JJ, “Prior admissions as a risk factor for readmission in patients surgically treated for femur fractures: Implications for a potential hip fracture bundle.,” NEOMED Bibliography Database, accessed July 31, 2021, https://neomed.omeka.net/items/show/11626.

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