Date of Award

2015

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Annie N. Simpson

Third Advisor

Tracy Eskra

Abstract

Hospital readmission reduction is the focus of many policy makers and healthcare providers to reduce the health care costs and improve quality. CMS initiated the Hospital Readmissions Reduction Program (HRRP) in October 2012. Financial penalties have been exercised for excessive readmission rates after heart failure, acute myocardial infarction, and pneumonia hospitalizations. The HRRP was expanded in federal fiscal year 2015 to include total joint arthroplasty. Total joint arthroplasty is the first procedure targeted for the readmission reduction program. The reasons for readmission after an elective surgical procedure may be different than the reasons for readmission after a medical condition such as heart failure. Using archival data from the 2012 Florida State Inpatient Database, the reasons for readmission within 30 days of discharge after a total joint arthroplasty were evaluated. Discharge data revealed 50, 769 primary total joint arthroplasties with a readmission rate of 5.1 %. The Medicare readmission rate was 5.8%. The most significant predictors of readmission were presence of chronic conditions and receipt of Medicaid benefits. Postoperative complications during the index admission did not significantly contribute to readmissions.

Rights

All rights reserved. Copyright is held by the author.

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