Postoperative Home Monitoring After Joint Replacement: Retrospective Outcome Study Comparing Cases With Matched Historical Controls

A retrospective cohort study was conducted in patients undergoing postoperative home monitoring (POHM) following elective primary hip or knee replacements. The objectives of our study were to compare the cost per patient, readmissions rate, emergency room visits, and mortality within 30 days to the...

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Bibliographic Details
Published in:JMIR perioperative medicine 2018-11, Vol.1 (2), p.e10169-e10169
Main Authors: Yang, Homer, Dervin, Geoff, Madden, Susan, Fayad, Ashraf, Beaulé, Paul, Gagné, Sylvain, Crossan, Mary Lou, Wheeler, Kathryn, Afagh, Melody, Zhang, Tinghua, Taljaard, Monica
Format: Article
Language:English
Subjects:
Anesthesia
Continuity of care
Costs
Demographics
Emergency medical care
Hospitals
Length of stay
Mortality
Original Paper
Patient care planning
Patient satisfaction
Software
Surgery
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Summary:A retrospective cohort study was conducted in patients undergoing postoperative home monitoring (POHM) following elective primary hip or knee replacements. The objectives of our study were to compare the cost per patient, readmissions rate, emergency room visits, and mortality within 30 days to the historical standard of care using descriptive analysis. After Research Ethics Board approval, patients who were enrolled and had completed a POHM study were individually matched to historical controls by age, American Society of Anesthesiology class, and procedure at a ratio 1:2. A total of 54 patients in the study group and 107 in the control group were eligible for the analysis. Compared with the historical standard of care, the average cost per case was Can $5826.32 (SD 1418.89) in the POHM group and Can $9198.58 (SD 1513.59) for controls. After 30 days, there were 2 emergency room visits (3.7%) and 0 readmissions in the POHM group, whereas there were 8 emergency room visits (7.5%) and 2 readmissions (1.9%) in the control group. No mortalities occurred in either group. The POHM study offers an early hospital discharge pathway for elective hip and knee procedures at a 38% reduction of the standard of care cost. The multidisciplinary transitional POHM team may provide a reliable forum to minimize readmissions, and emergency room visits within 30 days postoperatively. ClinicalTrials.gov NCT02143232; https://clinicaltrials.gov/ct2/show/NCT02143232 (Archived by WebCite at http://www.webcitation.org/73WQ9QR6P).
ISSN:2561-9128
2561-9128
DOI:10.2196/10169