Abstract
Introduction
Several studies have shown that functional outcomes are similar regardless of being discharged directly to home or to a rehabilitation center after total knee arthroplasty (TKA). Therefore, we sought to determine if there is a difference in patient care or patient satisfaction for patients discharged to in-patient rehabilitation or home-based rehabilitation.
Materials and Methods
Between February and May of 2015, one hundred and seventy one consecutive patients were prospective identified after undergoing TKA by one of three surgeons. At an average of six-weeks post TKA, all patients were asked a patient administered questionnaire to determine if diagnostic testing (ultrasounds, or x-rays) or blood transfusions were performed during the first-six weeks at either home (n=86) or a rehab (n=85) facility.
Results
Patients discharged to in-patient rehabilitation were found to be significantly older and sicker than patients discharged to home-based rehabilitation. Overall a greater number of diagnostic tests were performed on patient discharged to in-patient rehabilitation (23.5%) compared to patients discharged to home-based rehabilitation (8.1%) (p=0.032). Statistical analysis revealed discharge location, rather than age or health status, as the sole independent risk factor for a diagnostic testing being performed. The incidence of radiographs taken prior to the six week postoperative appointment was greater for patients discharged to rehab (10.6%) compared to those discharged home (1.1%) (p=0.008). There was no difference in the frequency of patients feeling like they received adequate physical therapy, adequate care or overall satisfaction. Twenty-nine (34.1%) patients were discharged under the care of the visiting nurse service after leaving the rehabilitation facility.
Conclusions
Patients discharged to a rehabilitation facility underwent more testing than patients discharged directly to home. There was no difference in the patient satisfaction or their perception of their overall care. Over a third of patients who go to Rehab are subsequently discharged home under the care of the visiting nurse service.
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