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

 

Yang H, Dervin G, Madden S, Fayad A, Beaulé P, Gagné S, Crossan ML, Wheeler K, Afagh M, Zhang T, Taljaard M. JMIR Perioperative Medicine. Vol 1, No 2 (2018): Jul-Dec.

ABSTRACT

Background:A retrospective cohort study was conducted in patients undergoing postoperative home monitoring (POHM) following elective primary hip or knee replacements.

Objective:The objectives were to compare cost per patient, readmissions rate, emergency room (ER) visits and mortality within 30-days to the historical standard of care using a descriptive analysis.

Methods:After Research Ethics Board approval, patients who were enrolled and completed a POHM study were individually matched to historical controls by age, American Society of Anesthesiology (ASA) class, & procedure at a ratio 1: 2.

Results:A total of 54 patients in the study group and 107 patients in the control were eligible for the analysis. Compared to the historical standard of care, the average cost per case was $5826.32(SD 1418.89) in the POHM group and $9198.58 (SD 1513.59) for controls. At 30-days, there were 2 ER visits (3.7%), and 0 readmissions in the POHM group, compared to 8 ER visits (7.5%) and 2 readmissions (1.9%) in the control group. There were no mortalities in either group.

Conclusions:The POHM study offers an early hospital discharge pathway for elective hip and knee procedures at a lower cost (38% reduction of the standard of care cost). The multi-disciplinary transitional POHM team may provide a reliable forum to minimize post-surgical 30-day; readmissions and emergency room visits.

ClinicalTrial:ClinicalTrials.gov NCT02143232

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