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Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward?
Background In an effort to rationalize National Health Service (NHS) funds in the United Kingdom, some hospitals have used the orthopaedic elective ring-fenced ward to admit general acute emergencies, admitting elective arthroplasty patients to general wards. Objective The aim of this study was to a...
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| Published in: | Applied health economics and health policy 2013-04, Vol.11 (2), p.151-154 |
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| container_end_page | 154 |
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| container_title | Applied health economics and health policy |
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| creator | Soler, J. Agustin Manjure, Sanjiv Kalairajah, Yegappan |
| description | Background
In an effort to rationalize National Health Service (NHS) funds in the United Kingdom, some hospitals have used the orthopaedic elective ring-fenced ward to admit general acute emergencies, admitting elective arthroplasty patients to general wards.
Objective
The aim of this study was to analyse the financial effect and length of stay of elective arthroplasty patients admitted to general wards rather than ‘ring-fenced’ orthopaedic wards.
Study Design
Retrospective observational study
Setting
Hospital care
Patients
During the period between 01 November 2010 and 31 March 2011, 194 consecutive patients were admitted for elective total hip and total knee arthroplasties. Due to increased bed pressures, 35 (18.04 %) of the patients were admitted to general wards instead of our standard elective ring-fenced orthopaedic ward. Data was collected and analysed for type of surgery, age, sex, length of stay, and ward.
Results
The average length of stay in the general wards was 1.89 days longer (range 3–22 days;
p
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| doi_str_mv | 10.1007/s40258-013-0018-0 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1323795401</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3146458261</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-9500b318ecd870243698395641eb883ce54d6918645c64b4c98e7c47ca621ee03</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotlZ_gBcJePGymsnXJieR0qpQLIjiMWyzU41sd2uyFfrv3VoVETzNwDzzzvAQcgzsHBjLL5JkXJmMgcgYg67ZIX2A3GZgrN797FWmtOI9cpDSK2Ncayv3SY8LaaUVuk_ubhMNLR2Huqh9KKpqTUfzefAB65a2DZ00CWn7gvQ-1M_ZGGuPJR1V6NvwjnQa25dmWWAZPH0qYnl5SPbmRZXw6KsOyON49DC8ySbT69vh1STzkqk2s4qxmQCDvjQ541Joa4RVWgLOjBEelSy1BaOl8lrOpLcGcy9zX2gOiEwMyNk2dxmbtxWm1i1C8lhVRY3NKjkQXORWyU7NgJz-QV-bVay77xxIrRgAh7yjYEv52KQUce6WMSyKuHbA3Ea228p2XaLbyHabJ06-klezBZY_G992O4BvgdSN6meMv07_m_oBbL-Gbw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1465011217</pqid></control><display><type>article</type><title>Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward?</title><source>EBSCOhost Econlit with Full Text</source><source>ABI/INFORM Global</source><source>Politics Collection</source><source>Springer Nature</source><source>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</source><source>PAIS Index</source><creator>Soler, J. Agustin ; Manjure, Sanjiv ; Kalairajah, Yegappan</creator><creatorcontrib>Soler, J. Agustin ; Manjure, Sanjiv ; Kalairajah, Yegappan</creatorcontrib><description>Background
In an effort to rationalize National Health Service (NHS) funds in the United Kingdom, some hospitals have used the orthopaedic elective ring-fenced ward to admit general acute emergencies, admitting elective arthroplasty patients to general wards.
Objective
The aim of this study was to analyse the financial effect and length of stay of elective arthroplasty patients admitted to general wards rather than ‘ring-fenced’ orthopaedic wards.
Study Design
Retrospective observational study
Setting
Hospital care
Patients
During the period between 01 November 2010 and 31 March 2011, 194 consecutive patients were admitted for elective total hip and total knee arthroplasties. Due to increased bed pressures, 35 (18.04 %) of the patients were admitted to general wards instead of our standard elective ring-fenced orthopaedic ward. Data was collected and analysed for type of surgery, age, sex, length of stay, and ward.
Results
The average length of stay in the general wards was 1.89 days longer (range 3–22 days;
p
< 0.001) than in the elective orthopaedic ward.
Conclusions
We conclude that losing the ring-fenced ward and admitting elective arthroplasty patients to general wards results in longer length of stay and a financial loss of 6.82 % per hip and knee arthroplasty patient.</description><identifier>ISSN: 1175-5652</identifier><identifier>EISSN: 1179-1896</identifier><identifier>DOI: 10.1007/s40258-013-0018-0</identifier><identifier>PMID: 23494936</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - economics ; Arthroplasty, Replacement, Knee - economics ; Cost analysis ; Cost control ; Disease control ; Efficiency ; Elective Surgical Procedures - economics ; Female ; Health Administration ; Health care industry ; Health Economics ; Health services ; Hospitals ; Humans ; Joint replacement surgery ; Joint surgery ; Length of stay ; Length of Stay - economics ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nursing ; Occupational therapy ; Orthopedics ; Orthopedics - economics ; Orthopedics - organization & administration ; Patient satisfaction ; Patients' Rooms - economics ; Pharmacoeconomics and Health Outcomes ; Physical therapy ; Public Health ; Quality of Life Research ; Research Letter ; Retrospective Studies ; Staphylococcus infections ; State Medicine - economics ; State Medicine - organization & administration ; Studies ; United Kingdom</subject><ispartof>Applied health economics and health policy, 2013-04, Vol.11 (2), p.151-154</ispartof><rights>European Union 2013</rights><rights>Copyright Wolters Kluwer Health Adis International Apr 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-9500b318ecd870243698395641eb883ce54d6918645c64b4c98e7c47ca621ee03</citedby><cites>FETCH-LOGICAL-c405t-9500b318ecd870243698395641eb883ce54d6918645c64b4c98e7c47ca621ee03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1465011217/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1465011217?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,11687,21386,21393,27865,27923,27924,33610,33611,33984,33985,36059,36060,43732,43947,44362,74092,74339,74766</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23494936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soler, J. Agustin</creatorcontrib><creatorcontrib>Manjure, Sanjiv</creatorcontrib><creatorcontrib>Kalairajah, Yegappan</creatorcontrib><title>Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward?</title><title>Applied health economics and health policy</title><addtitle>Appl Health Econ Health Policy</addtitle><addtitle>Appl Health Econ Health Policy</addtitle><description>Background
In an effort to rationalize National Health Service (NHS) funds in the United Kingdom, some hospitals have used the orthopaedic elective ring-fenced ward to admit general acute emergencies, admitting elective arthroplasty patients to general wards.
Objective
The aim of this study was to analyse the financial effect and length of stay of elective arthroplasty patients admitted to general wards rather than ‘ring-fenced’ orthopaedic wards.
Study Design
Retrospective observational study
Setting
Hospital care
Patients
During the period between 01 November 2010 and 31 March 2011, 194 consecutive patients were admitted for elective total hip and total knee arthroplasties. Due to increased bed pressures, 35 (18.04 %) of the patients were admitted to general wards instead of our standard elective ring-fenced orthopaedic ward. Data was collected and analysed for type of surgery, age, sex, length of stay, and ward.
Results
The average length of stay in the general wards was 1.89 days longer (range 3–22 days;
p
< 0.001) than in the elective orthopaedic ward.
Conclusions
We conclude that losing the ring-fenced ward and admitting elective arthroplasty patients to general wards results in longer length of stay and a financial loss of 6.82 % per hip and knee arthroplasty patient.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Hip - economics</subject><subject>Arthroplasty, Replacement, Knee - economics</subject><subject>Cost analysis</subject><subject>Cost control</subject><subject>Disease control</subject><subject>Efficiency</subject><subject>Elective Surgical Procedures - economics</subject><subject>Female</subject><subject>Health Administration</subject><subject>Health care industry</subject><subject>Health Economics</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Length of stay</subject><subject>Length of Stay - economics</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>Occupational therapy</subject><subject>Orthopedics</subject><subject>Orthopedics - economics</subject><subject>Orthopedics - organization & administration</subject><subject>Patient satisfaction</subject><subject>Patients' Rooms - economics</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Physical therapy</subject><subject>Public Health</subject><subject>Quality of Life Research</subject><subject>Research Letter</subject><subject>Retrospective Studies</subject><subject>Staphylococcus infections</subject><subject>State Medicine - economics</subject><subject>State Medicine - organization & administration</subject><subject>Studies</subject><subject>United Kingdom</subject><issn>1175-5652</issn><issn>1179-1896</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>7TQ</sourceid><sourceid>ALSLI</sourceid><sourceid>DPSOV</sourceid><sourceid>M0C</sourceid><sourceid>M2L</sourceid><recordid>eNp1kE1LAzEQhoMotlZ_gBcJePGymsnXJieR0qpQLIjiMWyzU41sd2uyFfrv3VoVETzNwDzzzvAQcgzsHBjLL5JkXJmMgcgYg67ZIX2A3GZgrN797FWmtOI9cpDSK2Ncayv3SY8LaaUVuk_ubhMNLR2Huqh9KKpqTUfzefAB65a2DZ00CWn7gvQ-1M_ZGGuPJR1V6NvwjnQa25dmWWAZPH0qYnl5SPbmRZXw6KsOyON49DC8ySbT69vh1STzkqk2s4qxmQCDvjQ541Joa4RVWgLOjBEelSy1BaOl8lrOpLcGcy9zX2gOiEwMyNk2dxmbtxWm1i1C8lhVRY3NKjkQXORWyU7NgJz-QV-bVay77xxIrRgAh7yjYEv52KQUce6WMSyKuHbA3Ea228p2XaLbyHabJ06-klezBZY_G992O4BvgdSN6meMv07_m_oBbL-Gbw</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Soler, J. Agustin</creator><creator>Manjure, Sanjiv</creator><creator>Kalairajah, Yegappan</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>4T-</scope><scope>7TQ</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DHY</scope><scope>DON</scope><scope>DPSOV</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>KC-</scope><scope>L.-</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2L</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward?</title><author>Soler, J. Agustin ; Manjure, Sanjiv ; Kalairajah, Yegappan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-9500b318ecd870243698395641eb883ce54d6918645c64b4c98e7c47ca621ee03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Hip - economics</topic><topic>Arthroplasty, Replacement, Knee - economics</topic><topic>Cost analysis</topic><topic>Cost control</topic><topic>Disease control</topic><topic>Efficiency</topic><topic>Elective Surgical Procedures - economics</topic><topic>Female</topic><topic>Health Administration</topic><topic>Health care industry</topic><topic>Health Economics</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Length of stay</topic><topic>Length of Stay - economics</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>Occupational therapy</topic><topic>Orthopedics</topic><topic>Orthopedics - economics</topic><topic>Orthopedics - organization & administration</topic><topic>Patient satisfaction</topic><topic>Patients' Rooms - economics</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Physical therapy</topic><topic>Public Health</topic><topic>Quality of Life Research</topic><topic>Research Letter</topic><topic>Retrospective Studies</topic><topic>Staphylococcus infections</topic><topic>State Medicine - economics</topic><topic>State Medicine - organization & administration</topic><topic>Studies</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soler, J. Agustin</creatorcontrib><creatorcontrib>Manjure, Sanjiv</creatorcontrib><creatorcontrib>Kalairajah, Yegappan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>PAIS Index</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>ProQuest One Community College</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Politics Collection</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Politics Collection</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Global</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Health Management Database (Proquest)</collection><collection>Medical Database</collection><collection>Political Science Database (Proquest)</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Applied health economics and health policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soler, J. Agustin</au><au>Manjure, Sanjiv</au><au>Kalairajah, Yegappan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward?</atitle><jtitle>Applied health economics and health policy</jtitle><stitle>Appl Health Econ Health Policy</stitle><addtitle>Appl Health Econ Health Policy</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>11</volume><issue>2</issue><spage>151</spage><epage>154</epage><pages>151-154</pages><issn>1175-5652</issn><eissn>1179-1896</eissn><abstract>Background
In an effort to rationalize National Health Service (NHS) funds in the United Kingdom, some hospitals have used the orthopaedic elective ring-fenced ward to admit general acute emergencies, admitting elective arthroplasty patients to general wards.
Objective
The aim of this study was to analyse the financial effect and length of stay of elective arthroplasty patients admitted to general wards rather than ‘ring-fenced’ orthopaedic wards.
Study Design
Retrospective observational study
Setting
Hospital care
Patients
During the period between 01 November 2010 and 31 March 2011, 194 consecutive patients were admitted for elective total hip and total knee arthroplasties. Due to increased bed pressures, 35 (18.04 %) of the patients were admitted to general wards instead of our standard elective ring-fenced orthopaedic ward. Data was collected and analysed for type of surgery, age, sex, length of stay, and ward.
Results
The average length of stay in the general wards was 1.89 days longer (range 3–22 days;
p
< 0.001) than in the elective orthopaedic ward.
Conclusions
We conclude that losing the ring-fenced ward and admitting elective arthroplasty patients to general wards results in longer length of stay and a financial loss of 6.82 % per hip and knee arthroplasty patient.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>23494936</pmid><doi>10.1007/s40258-013-0018-0</doi><tpages>4</tpages></addata></record> |
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| ispartof | Applied health economics and health policy, 2013-04, Vol.11 (2), p.151-154 |
| issn | 1175-5652 1179-1896 |
| language | eng |
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| source | EBSCOhost Econlit with Full Text; ABI/INFORM Global; Politics Collection; Springer Nature; Social Science Premium Collection (Proquest) (PQ_SDU_P3); PAIS Index |
| subjects | Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip - economics Arthroplasty, Replacement, Knee - economics Cost analysis Cost control Disease control Efficiency Elective Surgical Procedures - economics Female Health Administration Health care industry Health Economics Health services Hospitals Humans Joint replacement surgery Joint surgery Length of stay Length of Stay - economics Male Medicine Medicine & Public Health Middle Aged Nursing Occupational therapy Orthopedics Orthopedics - economics Orthopedics - organization & administration Patient satisfaction Patients' Rooms - economics Pharmacoeconomics and Health Outcomes Physical therapy Public Health Quality of Life Research Research Letter Retrospective Studies Staphylococcus infections State Medicine - economics State Medicine - organization & administration Studies United Kingdom |
| title | Is it Financially Efficient to Lose the Ring-Fenced Elective Orthopaedic Ward? |
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