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    Association Between Patient and Facility Characteristics and Rehabilitation Outcomes After Joint Replacement Surgery in Different Rehabilitation Settings for Older Adults: A Systematic Review

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    Authors
    Osundolire, Seun
    Mbrah, Attah
    Liu, Shao-Hsien
    Lapane, Kate L
    Student Authors
    Seun Osundolire
    UMass Chan Affiliations
    Morningside Graduate School of Biomedical Sciences
    Population and Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2023-01-04
    Keywords
    UMCCTS funding
    home health care
    inpatient rehabilitation
    skilled nursing facilities
    total hip replacement
    total knee replacement
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1519/jpt.0000000000000369
    Abstract
    Background and purpose: In the United States, an exponential increase in total hip arthroplasty (THA) and total knee arthroplasty (TKA) demand has occurred over the last 2 decades. Evidence suggesting patients receiving inpatient rehabilitation following a TKA or THA experience similar outcomes as those with rehabilitation in other settings led to dramatic shifts in postsurgical care settings owing to Centers for Medicare & Medicaid Services (CMS) payment reforms. A contemporary synthesis of evidence about the association between patient and facility factors and outcomes from older adults undergoing THA or TKA in the United States is needed. Methods: To identify eligible studies, we searched PubMed, Scopus, and CINAHL. We followed PRISMA guidelines to identify articles evaluating either patient or facility factors associated with outcomes after THA or TKA for older adults who may have been cared for in inpatient settings (ie, inpatient rehabilitation or skilled nursing facility [SNF]). Eligible articles were conducted in the United States and were published between January 1, 2000, and December 31, 2021. Results: We included 8 articles focused on patient factors and 9 focused on facility factors. Most included older adults and the majority were White (in those reporting race/ethnicity). Most studies evaluated outcomes at discharge and showed that patients admitted to inpatient rehabilitation facilities had either similar or better functional outcomes (mobility, self-care, and functional independence measure (FIM) score) and lower length of stay compared with those in SNFs. Few studies focused on home health care. Conclusions: The systematic review focused on older adults showed that findings in these patients are consistent with previous research. Older adults undergoing THA/TKA had acceptable outcomes regardless of postsurgical, inpatient setting of care. Research conducted after CMS payment reforms, in home health care settings, and in more diverse samples is needed. Given the known racial/ethnic disparities in THA/TKA and the shifts to postsurgical home health care with little regulatory oversight of care quality, contemporary research on outcomes of postsurgical THA/TKA outcomes is warranted.
    Source
    Osundolire S, Mbrah A, Liu SH, Lapane KL. Association Between Patient and Facility Characteristics and Rehabilitation Outcomes After Joint Replacement Surgery in Different Rehabilitation Settings for Older Adults: A Systematic Review. J Geriatr Phys Ther. 2023 Jan 4. doi: 10.1519/JPT.0000000000000369. Epub ahead of print. PMID: 36598848.
    DOI
    10.1519/JPT.0000000000000369
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/52086
    PubMed ID
    36598848
    Rights
    Copyright © 2023 APTA Geriatrics, An Academy of the American Physical Therapy Association.
    ae974a485f413a2113503eed53cd6c53
    10.1519/JPT.0000000000000369
    Scopus Count
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    Morningside Graduate School of Biomedical Sciences Scholarly Publications
    Population and Quantitative Health Sciences Publications
    UMass Center for Clinical and Translational Science Supported Publications

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