ArticleArthroplasty (London, England)2022
The combined effect of policy changes and the covid-19 pandemic on the same day discharge and complications following total hip arthroplasty: a nationwide analysis.
Article in Arthroplasty (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Geographic Variability in Medicare Hospital Reimbursement for Primary Total Hip and Knee Arthroplasty Episodes of Care From 2013 to 2023.Arthroplasty today · 2026Article
- The impact of COVID-19 in total hip arthroplasty: a comparison study in a center without elective surgery protocols.BMC musculoskeletal disorders · 2025Article
- Trends of robotic total joint arthroplasty utilization in the United States from 2010 to 2022: a nationwide assessment.Journal of robotic surgery · 2025Article
- The total joint arthroplasty care patterns in China during the COVID-19 pandemic: a multicenter cohort study.Frontiers in public health · 2024Article
- Article
- Decreasing length of stay in breast reconstruction patients: A national analysis of 2019-2020.Journal of surgical oncology · 2023Article
- Identifying Risk Factors for Complication and Readmission with Same-Day Discharge Arthroplasty.The Journal of arthroplasty · 2023Article
- Unexpected Repercussions of the COVID-19 Pandemic on Total Hip Arthroplasty with Cemented Hip Prosthesis versus Cementless Implants.Materials (Basel, Switzerland) · 2023Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs a result of the SARS-CoV-2 (COVID-19) pandemic in 2020, elective surgeries, including total joint arthroplasty (TJA), were suspended nationwide. Concurrent removal of total hip arthroplasty (THA) from the Medicare inpatient-only list posed challenges to the delivery of quality patient care with low payor cost. Therefore, the objective of this study was to compare temporal trends in patient demographics, case volumes, length of stay, and complications following elective THA in the years 2019 to 2020 in the United States.
methodsThe 2019 to 2020 ACS-NSQIP database was queried for elective THA patients. Patients Pre-COVID (2019 and 2020Q1) were compared with post-COVID (2020Q2-Q4). THA utilization, demographics, 30-day complications, and length of stay (LOS) were compared between years. Linear regression evaluated changes in case volumes over time with significance threshold of P < 0.05.
resultsA total of 77,797 patients underwent elective THA in 2019 (n = 43,667) and 2020 (n = 34,130), resulting in a 24.5% decline. Outpatient THA increased in 2020 (35.6%) vs. 2019 (5.7%) (P < 0.001). There was no significant difference in the volume of cases in 2019Q1 through 2019Q4 (P = 0.984). Elective THA volumes declined by 68.8% in 2020Q2, returned to pre-pandemic baseline in 2020Q3, before leveling off at 81.5% of baseline in Q4. Average LOS was significantly shorter in 2020 (1.55 days) vs. 2019 (1.78 days) (P < 0.001) and the proportion of same day discharge (SDD) increased quarterly from 2019 to 2020. There was no significant difference in the total complication rates in 2019 (6.6%) vs. 2020 (6.6%) (P = 0.831). DISCUSSION: Elective THA precipitously declined during the second quarter of 2020. The combined effect of policy changes and the COVID-19 pandemic resulted in a seven-fold increase in the number of surgeries performed in the outpatient setting in 2020. Rates of SDD doubled over the study period, despite no change in complication rates.
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