Does Patient Experience After a Total Knee Arthroplasty Predict Readmission?

To our knowledge, the relationship between patient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and patient outcomes in total knee arthroplasty (TKA) has not yet been analyzed. Therefore, the purpose of this study is to determine whether readmissions within the 30 or 90 days postoperative window after TKA were predicted by patient satisfaction scores, as measured by the HCAHPS survey.

We analyzed HCAHPS survey scores from all patients who underwent primary or revision TKA at our institution between January 1, 2016 and September 1, 2016. Demographic readmission information, preoperative baseline health status measures, validated patient-reported pain and joint function measures, and HCAHPS survey scores were collected. To determine whether 30-day or 90-day readmissions were independently associated with HCAHPS scores, statistical analyses were conducted using chi-squared and Student’s t-tests for categorical and continuous variables. Multivariable regression analysis adjusted for patient-level risk factors.

Patients readmitted within 30 days were significantly less likely to choose the highest rating on survey questions in several dimensions of patient satisfaction when compared to patients who were not readmitted. These dimensions included physician communication ( P = .045), discharge information ( P = .016), and transition of care ( P = .044). Similarly, patients who were readmitted within 90 days were less likely to choose the highest rating in survey questions that pertained to physician communication ( P = .046), medication information ( P = .040), and quietness of the hospital environment ( P = .048).

Our results show that readmission is predicted by lower patient satisfaction scores in several dimensions of patient care including physician communication, hospital environment, medication information, discharge information, and transition of care.