|Clinical pathway management of total knee arthroplasty.|
|PMID: 9418629 Owner: NLM Status: MEDLINE|
|Using a retrospective cohort study design, the authors examined complications, readmissions, morbidity and mortality, and function scores in two groups of patients attended by the same surgeon for the year before and the year after the implementation of an outcomes management program with clinical pathways for patients undergoing total knee arthroplasty at an academic health center. The effectiveness of the pathway constantly was adjusted using variance analysis and continuous quality improvement techniques. This program reduced the length of stay by 57% from a premanagement value of 10.9 +/- 5.4 days in 1994 (Group 1) to 4.7 +/- 1.4 days in 1996 (Group 2). Hospital costs (based on an inflation adjusted cost to charge ratio) for all total knees were reduced 11% from $13,328 +/- $3905 in 1994 to $11,862 +/- $4763 in 1996. Preoperative and postoperative knee scores were 41.1 +/- 16.3 and 84.2 +/- 16.0 for Group 1 and 42.5 +/- 13.0 and 87.0 +/- 10.4 for Group 2, respectively. There was no statistically significant difference between the preoperative or the postoperative knee scores of Groups 1 and 2. The application of clinical pathways, variance analysis, and continuous quality improvement toward the treatment of patients who had total knee arthroplasty at an academic health center resulted in significant savings in length of stay without adversely affecting overall outcome.|
|J D Mabrey; J S Toohey; D A Armstrong; L Lavery; L A Wammack|
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|Type: Journal Article|
|Title: Clinical orthopaedics and related research Volume: - ISSN: 0009-921X ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 1997 Dec|
|Created Date: 1998-01-21 Completed Date: 1998-01-21 Revised Date: 2005-03-03|
Medline Journal Info:
|Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: UNITED STATES|
|Languages: eng Pagination: 125-33 Citation Subset: AIM; IM|
|Department of Orthopaedics, University of Texas Health Science Center at San Antonio 78284-7774, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Academic Medical Centers
statistics & numerical data
Analysis of Variance
Arthroplasty, Replacement, Knee* / adverse effects, economics, mortality, statistics & numerical data
Length of Stay / statistics & numerical data
Outcome Assessment (Health Care)
Range of Motion, Articular
Texas / epidemiology
Total Quality Management
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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