Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter?
Purpose: With health-care utilization becoming an important factor in patient care, we investigated the effect that surgical day of week has on length of hospital stay (LOS) for shoulder arthroplasty patients. Methods: All patients undergoing primary anatomic or reverse total shoulder arthroplasty b...
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Series: | Journal of Shoulder and Elbow Arthroplasty |
Online Access: | https://doi.org/10.1177/2471549219832151 |
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doaj-950c5833233848bc9bd82da23292e0012020-11-25T03:25:45ZengSAGE PublishingJournal of Shoulder and Elbow Arthroplasty2471-54922019-02-01310.1177/2471549219832151Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter?Jeffrey D Osborne MDChristopher J Bush MDDenise M Koueiter MSJ Michael Wiater MDPurpose: With health-care utilization becoming an important factor in patient care, we investigated the effect that surgical day of week has on length of hospital stay (LOS) for shoulder arthroplasty patients. Methods: All patients undergoing primary anatomic or reverse total shoulder arthroplasty by a single surgeon on Monday, Wednesday, or Friday over a 10-year period were retrospectively reviewed. A total of 1784 patients met inclusion criteria. Demographics, LOS, and discharge disposition were recorded for all study participants. Results: The overall average LOS was 2.9 ± 1.8 days and was significantly longer for patients having surgery Friday (3.0 ± 1.9 days) versus Wednesday (2.7 ± 1.7 days, P = .002). For those discharged home, the mean LOS was 2.6 ± 1.3 days versus 4.3 ± 3.3 days for those discharged to extended care facilities (ECFs). Patients discharged to ECF with Friday surgery had a significantly longer LOS than Monday ( P = .028) and Wednesday ( P = .010) patients, with 30% of patients with Friday surgery being discharged postoperative day 4 versus 14% and 9% on Monday and Wednesday, respectively. LOS trended toward being longer for Friday surgery in the home disposition group but did not reach significance. Discussion: These results should be considered during surgical scheduling in order to minimize health-care expenditures. Patients at high risk for requiring ECF at discharge should be scheduled at the beginning of the week, while more resources are available to expedite their discharge.https://doi.org/10.1177/2471549219832151 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeffrey D Osborne MD Christopher J Bush MD Denise M Koueiter MS J Michael Wiater MD |
spellingShingle |
Jeffrey D Osborne MD Christopher J Bush MD Denise M Koueiter MS J Michael Wiater MD Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? Journal of Shoulder and Elbow Arthroplasty |
author_facet |
Jeffrey D Osborne MD Christopher J Bush MD Denise M Koueiter MS J Michael Wiater MD |
author_sort |
Jeffrey D Osborne MD |
title |
Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? |
title_short |
Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? |
title_full |
Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? |
title_fullStr |
Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? |
title_full_unstemmed |
Length of Stay in Total Shoulder Arthroplasty: Does Day of Surgery Matter? |
title_sort |
length of stay in total shoulder arthroplasty: does day of surgery matter? |
publisher |
SAGE Publishing |
series |
Journal of Shoulder and Elbow Arthroplasty |
issn |
2471-5492 |
publishDate |
2019-02-01 |
description |
Purpose: With health-care utilization becoming an important factor in patient care, we investigated the effect that surgical day of week has on length of hospital stay (LOS) for shoulder arthroplasty patients. Methods: All patients undergoing primary anatomic or reverse total shoulder arthroplasty by a single surgeon on Monday, Wednesday, or Friday over a 10-year period were retrospectively reviewed. A total of 1784 patients met inclusion criteria. Demographics, LOS, and discharge disposition were recorded for all study participants. Results: The overall average LOS was 2.9 ± 1.8 days and was significantly longer for patients having surgery Friday (3.0 ± 1.9 days) versus Wednesday (2.7 ± 1.7 days, P = .002). For those discharged home, the mean LOS was 2.6 ± 1.3 days versus 4.3 ± 3.3 days for those discharged to extended care facilities (ECFs). Patients discharged to ECF with Friday surgery had a significantly longer LOS than Monday ( P = .028) and Wednesday ( P = .010) patients, with 30% of patients with Friday surgery being discharged postoperative day 4 versus 14% and 9% on Monday and Wednesday, respectively. LOS trended toward being longer for Friday surgery in the home disposition group but did not reach significance. Discussion: These results should be considered during surgical scheduling in order to minimize health-care expenditures. Patients at high risk for requiring ECF at discharge should be scheduled at the beginning of the week, while more resources are available to expedite their discharge. |
url |
https://doi.org/10.1177/2471549219832151 |
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