Approaches to Delivery of Care at Home Following Elective Hip and Knee Joint Replacement Surgery

Abstract

Arthritis has a worldwide increasing prevalence with increased demands on healthcare systems to provide arthroplasty surgery. There is growing evidence that early discharge and rehabilitation at home following hip and knee replacement provide similar or better results in function, complication rates and patient satisfaction. We suggest that this method of rehabilitation is a cost-effective viable option in fitter patients whose medical demands will be low postoperatively.

Reductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England

“…19 Each intervention may have affected both readmission rates (eg, by strengthening the patients’ ability to self-care, including managing pain or dressing wounds) and patient-reported health outcomes such as mobility or pain (eg, through exercise management). However, even though specific interventions have been evaluated individually, 20 it is still unclear whether, at a system level, reductions in readmission rates have coincided with improvements in broader patient outcomes. Assessing the association between these 2 is critical because of concerns that, by incentivizing hospitals to reduce readmission rates, there may have been unintended consequences for other aspects of care quality, 21 – 24 for example, if the penalties displaced follow-up activity from inpatient settings to other care settings (such as observation units) that are not included in the readmission metrics yet might have implications for patient care 4 ; or had disproportionate impacts on some hospitals groups.…”