A Preliminary Examination of the CMS Eligibility Criteria in Total-Joint Arthroplasty.

Vincent, Kevin R. MD, PhD;  Lee, Laura W. MD, MBA;  Weng, JenPin MD;  Alfano, Alan P. MD;  Vincent, Heather K. PhD

The objective of this study was to analyze inpatient rehabilitation outcomes in total-knee arthroplasty (TKA) and total-hip arthroplasty (THA) patients using the 2004 Medicare 75% rule criteria.  This retrospective study compared outcomes in unilateral TKA (UTKA), bilateral TKA (BTKA), and THA after interdisciplinary inpatient rehabilitation. Patients were separated into three comparison pairs: 1) UTKA or BTKA, 2) age <85 yrs or >=85 yrs, and 3) body mass index (BMI) <50 or >=50 kg/m2. Length of stay (LOS), functional independence measure (FIM) scores, hospital charges, FIM efficiency, and discharge disposition were analyzed.  The article describes how all patients made functional gains during rehabilitation. However, the most costly and lengthy rehabilitation occurred in TKA patients >=85 yrs and THA patients with BMI >=50 kg/m2.

American Journal of Physical Medicine & Rehabilitation.    85(11):872-881, November 2006.

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