failure. These patients demand consistent monitoring, in-home nurs-
ing and physical therapy in the days and weeks that follow surgery,
care that same-day discharges and non-clinician caregivers can't guar-
antee. Here's what you need to know about this sometimes over-
looked aspect of total joint surgery.
Why home recovery makes sense
Discharging total joint patients within hours of their surgeries and, by
association, having them start their recoveries at home, offers advan-
tages on both economical and clinical fronts.
One of the chief aims of the Affordable Care Act — and of
Medicare's recently proposed Comprehensive Care for Joint
Replacement payment model, slated to take effect in select mar-
kets in January — is promoting high-quality health care while
reducing the costs of that care. One cost-effective tactic that fre-
quently delivers value is shortening the lengths of hospital stays,
when possible.
A hospital stay can cost roughly $2,500 to $3,500 per day, and some-
times insurers dictate a hospital stay, but if not, every day earlier that
you can safely discharge a patient saves a substantial sum of money.
Certainly you could refer patients to a skilled nursing facility, which is
a comparative bargain at about $414 per day, but an adequate home
recovery model can cost about $62 per day.
Home recovery also carries benefits for patient outcomes. Studies
show that the longer a patient stays in the hospital, the higher the risk of
surgical site infection, so speedy discharge and at-home care might actu-
ally reduce the risk of post-op complications as well as hospital readmis-
sions.
It's providing them with an encouraging shot of motivation, too. It
stands to reason that outpatient total joints programs are seeing
6 5
O C T O B E R 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T