Evidence map›Paper›PMID 35760109›Full record

ArticleArchives of physical medicine and rehabilitation2022

The Effect of CMS's Comprehensive Care for Joint Replacement Bundled Payment Model on Trajectories of Post-acute Rehabilitation Care After Total Hip Arthroplasty.

Kara Kallies, Timothy R Dillingham, Adam Edelstein, Eric Hume, Daniel Polsky, Roy Schwartz, Emily L McGinley, Liliana E Pezzin

Open access · greenAbstract read
In one paragraph

Article in Archives of physical medicine and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Kara KalliesInstitute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI.
Timothy R DillinghamDepartment of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA. Electronic address: Timothy.Dillingham@pennmedicine.upenn.edu.
Adam EdelsteinDepartment of Orthopedic Surgery, Northwestern University, Chicago, IL.
Eric HumeDepartment of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA.
Daniel PolskyBloomberg School of Public Health, the Johns Hopkins University, Baltimore, MD.
Roy SchwartzUniversity of Pennsylvania, Phialdelphia, PA.
Emily L McGinleyCenter for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee, WI.
Liliana E PezzinInstitute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI.
Medical College of Wisconsin · USUniversity of Pennsylvania · USJohns Hopkins University · USNorthwestern University · US

Funding

Evaluating the Effects of CMS' Prospective Episode-Based "Bundling" Payment Model for Lower Limb Joint Replacement: Post-acute Care Setting, Costs and Patient OutcomesR01AG058718 · NIA · UNIVERSITY OF PENNSYLVANIA · PI DILLINGHAM, TIMOTHY R, PEZZIN, LILIANA E. · 2018 to 2021
$1.5M
NIA NIH HHS R01 AG058718
6 · The paper itself

Abstract

objectiveTo evaluate the effect of the Comprehensive Care for Joint Replacement (CJR) policy on the 90-day trajectory of post-acute care after a total hip arthroplasty (THA).

designMultivariable difference-in-difference models applied to Medicare beneficiaries undergoing a THA prior to (2014-2015) and post-CJR implementation (2017) in areas subjected to or exempt from the policy.

settingHospitals in standard metropolitan statistical areas.

participants357,844 elderly Medicare patients nationwide undergoing THA (N=357,844).

interventionsNone.

main outcome measuresEscalation in care to institutionalization (ie, admission to an inpatient rehabilitation or skilled nursing facility during 90-days postdischarge for those initially discharged to the community and return to the community at the end of the episode of care among those initially discharged to an institutional setting).

resultsOf the 357,844 elderly Medicare patients nationwide undergoing THA during the study period, 47.6% were discharged directly to the community and 52.4% received post-acute care in an institution. Patients discharged to an institution post-policy in a CJR area were about 10% less likely to return to the community (odds ratio=0.91; 95% confidence interval, 0.84-0.98; P=.02) at the end of the 90-day episode of care than those treated in policy-exempt areas. Despite the large magnitude, estimates of escalation in care among patients treated in bundling areas post-CJR implementation were not statistically significant.

conclusionsOur findings support further exploration of unanticipated effects of mandatory bundled payment policies on outcomes, as well as further examination of outcomes among policy-relevant subgroups of patients undergoing hip replacement in the United States.

Indexed as

Arthroplasty, Replacement, HipAftercareAgedCenters for Medicare and Medicaid Services, U.S.HumansMedicarePatient DischargeSubacute CareUnited StatesArthroplastiesPatient Care BundlesPost-acute CareRehabilitation

Identifiers

PMID35760109
PMCPMC9729363
OpenAlexW4283585277

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.