Inpatient rehabilitation hospital charges following primary and revision total hip arthroplasty

Abstract

Purpose of review: Total-hip-arthroplasty procedural rates are rising, concurrent with referral rates of patients undergoing total hip arthroplasty to inpatient-rehabilitation hospitals. In the era of complex medical decision-making and cost-reducing measures, an understanding of the factors that influence inpatient-rehabilitation costs in this population is critical. The purpose of this paper is to identify several factors that directly or indirectly influence inpatient-rehabilitation costs with total-hip-arthroplasty rehabilitation, and suggests potential strategies to reduce costs within the inpatient-rehabilitation hospital with this population. Recent findings: Multiple factors were identified that influenced inpatient-rehabilitation hospital costs, including admission status of the patient, surgical type (primary or revision total hip arthroplasty), etiologic diagnosis for total hip arthroplasty, patient characteristics, comorbidity number and type and use of hip abductor braces or orthoses during the inpatient-rehabilitation stay. Summary: Revision total-hip-arthroplasty procedures, especially in older women, incur greater inpatient-rehabilitation costs than primary procedures. Comorbidity type and lower functional status at admission also adversely affect inpatient-rehabilitation costs. Identification of patients best suited for rehabilitation following total hip arthroplasty, optimizing pain-control regimens, prearthroplasty rehabilitation and potentially preoperative educational methods in the appropriate patient may reduce costs in the inpatient-rehabilitation hospital.