October 22, 2014
1 min read

Preoperative physical therapy decreased need for post acute care services after TJA

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Among patients who underwent primary hip or knee arthroplasty, those who participated in preoperative physical therapy had a 29% decrease in the use of any post-acute care services, according to study results.

Using the CMS Limited Data Set files for Diagnosis Related Group 470, researchers analyzed historical claims data, including descriptive statistics of patient demographic characteristics, comorbidities, procedures and post-acute care utilization patterns. Post-acute care utilization patterns included skilled nursing facility, home health agency or inpatient rehabilitation facility during the 90-day period after a surgical hospitalization.

Bivariate and multivariate techniques focused on post-acute care use and total episode-of-care costs were used to evaluate associations.

Within the 39-county Medicare hospital-referral cluster, the Limited Data Set provided 4,733 index hip or knee replacement cases for analysis. Study results showed post-acute care utilization was a significant variable in the total cost of care for the 90-day episode, and that 77% of patients used post-acute care services after surgery.

Although only 54.2% of the preoperative physical therapy cohort utilized post-acute care services, 79.7% of the non-preoperative physical therapy cohort used post-acute care services.

The researchers found a significant 29% reduction in post-acute care use associated with use of preoperative physical therapy, which included an $871 reduction of episode payment, resulting mainly from a reduction in payments for skilled nursing facility, home health agency and inpatient rehabilitation.

Disclosures: McShane received personal fees and non-financial support from Zimmer. Wasielewski received personal fees from DePuy and Zimmer. Granata received travel reimbursement from OhioHealth Research Institute.