[Total Hip and Knee Arthroplasty - Utilization of Postoperative Rehabilitation].

BACKGROUND: After total hip and knee arthroplasty, patients have different options of subsequent treatment: an early postoperative rehabilitation, with or without a period at home, or only outpatient services. The aim of this study was to identify factors predicting the utilization of an early postoperative rehabilitation.

METHODS: This cross-sectoral analysis is based on claims data of AOK Baden-Württemberg (Statutory Health Insurance), Deutsche Rentenversicherung Bund and Deutsche Rentenversicherung Baden-Württemberg (German Pension Insurance). Predictors for participation in an early postoperative rehabilitation and for an interim period were determined using logistic regression analysis.

RESULTS: 82.6% of 9 232 patients were going to an early postoperative rehabilitation after total hip arthroplasty. After total knee arthroplasty, 83.9% of 7 656 patients were utilizing postoperative rehabilitation. Moreover, there was less utilization of postoperative rehabilitation in young, male and foreign patients. The analysis shows that the utilization of post-acute rehabilitation was significantly predicted by sociodemographic variables (age, sex, nationality) as well as comorbidity, outpatient treatment and medication.

CONCLUSION: The results provide an indication of higher severity of patients in group "postoperative rehabilitation without a period at home". Nevertheless there are some indications for under-utilization of certain patient groups.