A recent study suggests that physical therapy prior to joint replacement surgery can help diminish the need for postoperative care by nearly 30%. According to the results, this translates into saving an average of $1,215 per patient in skilled nursing facility, home health agency, or other postoperative care.
A news release from the American Academy of Orthopaedic Surgeons (AAOS) reports that the number of total hip replacements (THRs) is expected to grow by 174% between 2005 and 2030, and total knee replacements (TKRs) by 673%. The release adds that in recent years, while the length of hospital stays post-surgery has decreased from an average of 9.1 days in 1990 to 3.7 days in 2008, the cost of post-acute care, primarily in skilled nursing facilities and home health agencies, has increased.
According to the release, the researchers used Medicare claims data to pinpoint both preoperative physical therapy and postoperative care usage patterns for 4,733 THR and TKR patients. Postoperative, or “post-acute” care was defined as the use of a skilled nursing facility, home health agency, or inpatient rehabilitation center within 90 days after hospital discharge. Researchers say home health agency services encompassed skilled nursing care, home health aides, physical therapy, speech therapy, occupational therapy, and medical social services.
Approximately 77% of patients used care services post-surgery, the release notes. After adjusting for demographic characteristics and comorbidities, patients receiving preoperative physical therapy exhibited a 29% reduction in postoperative care use.
Additionally, the results indicate that 54.2% of the preoperative physical therapy group required postoperative care services, compared to 79.7% of the patients who did not have preoperative therapy. The results also suggest that the decline in postoperative care services translated into an adjusted cost reduction of $1,215 per patient, largely as the result of lower costs for skilled nursing facility and home health agency care. The study also states that preoperative physical therapy cost an average of $100 per patient, and was generally limited to one or two sessions.
In the AAOS release, Ray Wasielewski, MD, study co-author, notes that “This study demonstrated an important opportunity to pre-empt postoperative outcome variances by implementing preoperative physical therapy along with management of comorbidities before and during surgery.”