There has long been a debate over sending a patient to a post-acute facility versus utilizing at-home rehabilitation following joint replacement surgery. However, being at home, even if someone lives alone, can be more beneficial than going from the hospital to a post-acute facility, according to a recent article from The New York Times.
The number of people receiving joint replacements, specifically knee and hip replacements, is increasing due to the fact that people are living longer. Along with the increase in joint replacements comes the increased need for rehabilitation services, and in-home services may be less expensive with comparable, if not better, outcomes than inpatient rehab facilities, the article reported.
There needs to be a re-examination of who, if anyone, should go to a rehab facility after joint replacement, Dr. Javad Parvizi, chairman of research in orthopedics at Thomas Jefferson University, explained in the article.
In one of Dr. Parvizi’s studies he worked with 769 patients who underwent either a knee or hip replacement for advanced arthritis. Of the patients, 36 were discharged from the hospital to a rehab facility, and the rest went home and received outpatient rehab, even those who lived alone.
“Based on an assessment of the patients’ function, pain relief and personal satisfaction three months after their surgery, the team concluded, ‘Patients living alone can expect a safe recovery, equivalent to those not living alone, when discharged directly home after total joint arthroplasty,’” the article stated.
Another potential perk of in-home rehab services is that patients who go directly home from after joint replacement surgery may be less likely to experience adverse events like blood clots and infections. This is because there was “substandard treatment, inadequate patient monitoring, and failure to provide needed treatment” at inpatient facilities.
Cost is also a huge differentiator between inpatient and in-home rehab. Inpatient rehabilitation is typically much more expensive than receiving in-home services. Dr. Parvizi’s study found that the cost per patient is reduced by more than $10,000 without inpatient rehab.
Read the full article from The New York Times.