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The Effect of Length of Stay and Discharge Disposition on Hospital Consumer Assessment of Healthcare Providers and Systems Scores in Orthopaedic Patients

Shulman, Brandon, MD; Hutzler, Lorraine, MPA; Karia, Raj, MPH; Bosco, Joseph, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May 1, 2019 - Volume 27 - Issue 9 - p e418–e422
doi: 10.5435/JAAOS-D-17-00552
Research Article

Background: The study assesses whether Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores were influenced by hospital length of stay (LOS) and discharge disposition.

Methods: HCAHPS scores from 5,682 orthopaedic patients were collected over a 4-year period. Statistical analyses were run to identify associations between Top-Box scores for each HCAHPS domain and LOS or discharge disposition (home versus rehabilitation facility).

Results: Decreased LOS was associated with increased HCAHPS Top-Box scores for every Top-Box domain except for Discharge composite (P ≤ 0.001 to 0.011). Discharge to home was associated with increased HCAHPS scores for four Top-Box domains (P ≤ 0.001 to 0.009).

Discussion: Shorter LOS and discharge to home after orthopaedic surgery are associated with better HCAHPS scores. Earlier discharge leads to an improved patient-reported experience and can increase reimbursements. Expedient, appropriate discharge of hospitalized orthopaedic patients should be a treatment goal after orthopaedic surgery.

From NYU Langone Orthopedic Center, Department of Orthopedic Surgery, New York City, NY.

Correspondence to Ms. Hutzler:

Dr. Bosco or an immediate family member has received royalties from Genovel; is a member of a speakers' bureau or has made paid presentations on behalf of Pacira; serves as a paid consultant to Genovel, Labrador Healthcare, Medtronic, and Surgical Directions Consulting; has stock or stock options held in Genovel; and serves as a board member, owner, officer, or committee member of the Orthopaedic Learning Center. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Shulman, Ms. Hutzler, and Mr. Karia.

© 2019 by American Academy of Orthopaedic Surgeons
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