Decreasing Length of Stay After Total Joint Arthroplasty: Effect on Referrals to Rehabilitation Units.Forrest GP, Roque roque: see croquet. JM, Dawodu ST (Department of Physical Medicine and Rehabilitation physical medicine and rehabilitation or physiatry or physical therapy or rehabilitation medicine Medical specialty treating chronic disabilities through physical means to help patients return to a comfortable, productive life despite a medical , Albany Medical Center, Albany, NY), Arch Phys Meal Rehabil. 1999;80:192-194. This study examined the relationship of 6 factors on the number of referrals to rehabilitation rehabilitation: see physical therapy. : patient age, sex, living situation, score on the American Society of Anesthesiologists The American Society of Anesthesiologists (ASA) is an association of physicians (primarily anesthesiologists) whose stated goal is to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient. (ASA Asa (ā`sə), in the Bible, king of Judah, son and successor of Abijah. He was a good king, zealous in his extirpation of idols. When Baasha of Israel took Ramah (a few miles N of Jerusalem), Asa bought the help of Benhadad of Damascus and ) physical status measure, operating surgeon, and length of stay in a surgical unit. In 1997, 130 patients were consecutively admitted by 15 surgeons for total hip or knee cemented replacements; 129 of these patients were eligible for review. Primary procedures were performed in 122 patients of whom 66 had hip arthoplasties. Seventy-seven patients were 65 years or older, 74 were women, and 95 expected to be living with family or friends when discharged. The patients were classified on the 5-point ASA physical status scale where 1 was defined as "no systemic disease A systemic disease is one that affects a number of organs and tissues, or affects the body as a whole [1] Although most medical conditions will eventually involve multiple organs in advanced stage (i.e. " and 5 represented a "50% risk of dying within one day." The highest score noted in the patients in the study was 4, which was defined as "severe life-threatening disease that markedly limits activity." For comparison of length of stay and number of referrals to rehabilitation, 125 records of patients admitted to the same facility for the same procedures 2 years earlier were analyzed an·a·lyze tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es 1. To examine methodically by separating into parts and studying their interrelations. 2. Chemistry To make a chemical analysis of. 3. . The average length of stay in 1995 was 6.4 days compared with 5.1 days in 1997, and the referrals to rehabilitation rose from 13% to 33%. These findings were the only statistically significant differences between the 2 groups. Over 45% of those 65 years or older were referred to rehabilitation, compared with 13.5% of those who were younger. Fifty percent of those living alone were referred to rehabilitation, compared with a 28% rate for patients who were returning to family or friends. None of those with an ASA physical status score of 1 (6 patients) was referred for rehabilitation, whereas 75% of those with a score of 4 (4 patients) were referred for rehabilitation. Of those patients with scores of 2 and 3, 27.5% and 42% were referred to rehabilitation, respectively. There was no significant difference in rehabilitation referrals as it related to sex or referring surgeon. Using one facility as a guide, the authors compared the savings in days and costs in acute care with the increase in days and cost in rehabilitation. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the authors, there was an overall net increase in days within a facility, but, with the lower costs of rehabilitation, there was slight decrease in overall costs. Barbara Hanley, PT Helen Hayes Hospital West Haverstraw, NY |
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