Joint Recovery Programme Versus Usual Care
- 1 October 2005
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Medical Care
- Vol. 43 (10), 1018-1026
- https://doi.org/10.1097/01.mlr.0000178266.75744.35
Abstract
The objective of the present study was to determine the incremental cost-effectiveness of a clinical pathway for patients undergoing joint replacement, the Joint Recovery Programme (JRP), as compared with usual care. The existing care process was revised to contain costs and shorten waiting lists by facilitating patient flows and improve healthcare efficiency. The study design was a before–after trial. In total, 160 patients undergoing total hip and total knee replacement, aged 28 to 87 years (mean age, 64.4 years), were treated either according to the Joint Recovery Programme (a standardized care process with patient education and rehabilitation in groups) or usual care. Both groups were followed for 1 year. Costs were studied from a societal perspective. Outcomes included functional level (Harris Hip score and American Knee Society score) and generic quality of life (EuroQol). The results indicate that the Joint Recovery Programme resulted in a significant cost saving when compared with usual care mainly as a result of a considerable (>50%) reduction in length of hospital stay. The average cost saving per patient amounted to $1261 in the total hip replacement group and $3336 in the total knee replacement group. At the same time, both functional level and quality of life were higher in the JRP group. Clinical pathway dominates usual care and is a highly cost-effective approach to contain costs related to joint replacement surgery without adverse consequences for patients.Keywords
This publication has 31 references indexed in Scilit:
- Effectiveness of clinical pathways for total knee and total hip arthroplastyLiterature reviewThe Journal of Arthroplasty, 2003
- Outcomes Assessment of Total Hip and Total Knee ArthroplastyClinical Nurse Specialist, 1998
- Effect of preparatory information prior to elective total hip replacement on post-operative physical coping outcomesInternational Journal of Nursing Studies, 1996
- Health‐related quality of life in patients with osteoarthritis in a family practice settingArthritis & Rheumatism, 1995
- The friction cost method for measuring indirect costs of diseaseJournal of Health Economics, 1995
- Costs, effects and C/E‐ratios alongside a clinical trialHealth Economics, 1994
- KNEE PAIN AND DISABILITY IN THE COMMUNITYRheumatology, 1992
- Functional Improvement and Costs of Hip and Knee Arthroplasty in Destructive Rheumatoid ArthritisScandinavian Journal of Rheumatology, 1991
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990
- Rationale, of The Knee Society Clinical Rating SystemClinical Orthopaedics and Related Research, 1989