Reduced length of uninterrupted institutional stay after implementing a fast-track protocol for primary total hip replacement

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dc.contributor Aalto-yliopisto fi
dc.contributor Aalto University en Pamilo, Konsta J. Torkki, Paulus Peltola, Mikko Pesola, Maija Remes, Ville Paloneva, Juha 2018-09-06T10:17:03Z 2018-09-06T10:17:03Z 2018-02
dc.identifier.citation Pamilo , K J , Torkki , P , Peltola , M , Pesola , M , Remes , V & Paloneva , J 2018 , ' Reduced length of uninterrupted institutional stay after implementing a fast-track protocol for primary total hip replacement : Register-based analysis of 4 hospitals and 3,193 replacements ' ACTA ORTHOPAEDICA , vol 89 , no. 1 , pp. 10-16 . DOI: 10.1080/17453674.2017.1370845 en
dc.identifier.issn 1745-3674
dc.identifier.other PURE UUID: 950c3063-298e-48a6-906e-9ba7b1698aec
dc.identifier.other PURE ITEMURL:
dc.identifier.other PURE FILEURL:
dc.description.abstract Background and purpose - Fast-track protocols have been successfully implemented in many hospitals as they have been shown to result in shorter length of stay (LOS) without compromising results. We evaluated the effect of fast-track implementation on the use of institutional care and results after total hip replacement (THR). Patients and methods - 3,193 THRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast-track (Hospital A) and non-fast-track (Hospitals B, C, and D). We analyzed LOS, length of uninterrupted institutional care (LUIC, including LOS), discharge destination, readmission, revision rate, and mortality in each hospital. We compared these outcomes for THRs performed in Hospital A before and after fast-track implementation and we also compared outcomes, excluding readmission rates, with the corresponding outcomes for the other hospitals. Results - After fast-track implementation, median LOS in Hospital A diminished from 5 to 2 days (p <0.001) and (median) LUIC from 6 to 3 (p = 0.001) days. No statistically significant changes occurred in discharge destination. However, the reduction in LOS was combined with an increase in the 42-day readmission rate (3.1% to 8.3%) (p <0.001). A higher proportion of patients were at home 1 week after THR (p <0.001) in Hospital A after fast-tracking than before. Interpretation - The fast-track protocol reduces LUIC but needs careful implementation to maintain good quality of care throughout the treatment process. en
dc.format.extent 7
dc.format.extent 10-16
dc.format.mimetype application/pdf
dc.language.iso en en
dc.relation.ispartofseries ACTA ORTHOPAEDICA en
dc.relation.ispartofseries Volume 89, issue 1 en
dc.rights openAccess en
dc.subject.other 520 Other social sciences en
dc.title Reduced length of uninterrupted institutional stay after implementing a fast-track protocol for primary total hip replacement en
dc.type A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä fi
dc.description.version Peer reviewed en
dc.contributor.department Jyvaskyla Central Hospital
dc.contributor.department Department of Industrial Engineering and Management
dc.contributor.department National Institute for Health and Welfare
dc.contributor.department Pihlajalinna Group
dc.subject.keyword TOTAL JOINT REPLACEMENT
dc.subject.keyword KNEE ARTHROPLASTY
dc.subject.keyword PRIMARY THA
dc.subject.keyword OF-STAY
dc.subject.keyword MORTALITY
dc.subject.keyword VOLUMES
dc.subject.keyword COMPLICATIONS
dc.subject.keyword PREDICTORS
dc.subject.keyword 520 Other social sciences
dc.identifier.urn URN:NBN:fi:aalto-201809064980
dc.identifier.doi 10.1080/17453674.2017.1370845
dc.type.version publishedVersion

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