Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111944

Karin Greenberg, DO, National Rehabilitation Hospital (NRH), 102 Irving Street, NW, Washington, DC 20010 and Thilo Kroll, PhD, University of Dundee, School of Nursing and Midwifery, 11 Airlie Place, Dundee DD1 4HJ, Scotland, United Kingdom, +44 (0) 1382 348 655, t.kroll@dundee.ac.uk.

Objective. Obesity is a costly public health issue in the United States. The number of individuals undergoing total hip arthroplasty (THA) is also increasing. This study examines the relation between body weight, demographic and clinical characteristics, insurance and lengths of stay (LOS) in an acute rehabilitation hospital after THA.

Methods. A retrospective chart review was conducted for 119 individuals (Mdn age=68; 69.7% female) who were treated at the National Rehabilitation Hospital between September 2002 and February 2004. Independent variables included age, gender, race, health insurance, comorbid conditions, days between THA and discharge from rehabilitation, discharge to home/other, and body mass index (BMI). Dependent variables were length of stay and BMI. We conducted bivariate and logistic regression analyses.

Results. The bivariate crosstabulation analysis showed that there was no significant association between length of stay and BMI after THA. Similarly, age, gender, and number of comorbid conditions were not associated with the LOS. The only significant association for LOS was found for insurance type and race. Logistic regression analyses showed that insurance type and race/ethnicity as significant predictors of LOS. Patients receiving Medicare and Non-Caucasian patients were more likely to stay longer in hospital after THA.

Conclusions. The significant predictors ‘insurance type' and ‘race/ethnicity' point to underlying economic disparities. Chart reviews are limited in being retrospective and terms of variable quality of documentation over time. The relationship between obesity and LOS needs further clarification in terms of outcomes after THA and the cost-effectiveness of treatments that may be compromised by preventable complications.

Learning Objectives:

• To discuss the impact of obesity on rehabilitative outcomes
• To analyze predictors of length of stay after total hip replacement
• To identify limitations of chart review studies

Keywords: Obesity, Health Service

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.