Studies have shown that patients who go home after a total hip or knee replacement report higher satisfaction, better overall outcomes, and it also saves the hospitals money. Some people would say that the better outcomes occur because the patients healthy enough to go home are set up to do better (its a selected population, and not related to actually going home). Therefore, you cannot generalize about what is best for "patients" as a whole, however, you can look at all the variables that determine where people go after surgery and then use that information to help guide where you will go after your total hip or total knee replacement.
Here are a few things that have been shown to affect where people go after their surgery: ethnicity, gender, age, living arrangements, insurance status, expectations, and postop length of hospital stay.
One recent study found the following variables associated with increased likelihood of going to a rehab center after a joint replacment: female gender, total knee replacement (vs. total hip), lower-to-mid social economic status, black ethnicity, advanced age (>70 years old).
Theres findings have been demonstrated in other studies as well. In general lower socioeconomic status is associated with worse outcomes after joint arthroplasty, probably because of less access to physical therapy and assistance after surgery. Female gender was the most important predictor, with almost twice as many going to a rehab facility. Black ethnicity was associated with discharge location in only one other study, and in this recent study, once medical insurance and age were accounted for in the analysis, ethnicity no longer played a significant role.
It is therefore important for patients and surgeons to recognize some of these proposed variables which helps to predict where patients are likely to go after surgery. This helps with postoperative planning for patients and family members.
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