The Economic Impact of a Pilot Digital Day-Case Pathway for Knee Arthroplasty in a UK Setting

Background: Knee replacements are an increasingly common procedure in the U.K. National Health Service (NHS). Importantly, the pathway for such procedures represents a prime opportunity to leverage digital technology, modernize and streamline the approach to care, and free up resources.Methods: In this 21-patient pilot study, we assessed the impact of implementing a digital day-case pathway for knee replacement surgery at the Calderdale and Huddersfield NHS Foundation trust.Results: Fourteen (67%) of the 21 eligible patients were treated as day cases, with an average length of stay of 8.8 hours. The pilot data were utilized to model the potential impact of implementing a digital day-case program more widely across the trust. This model showed increased efficiency over the entire episode of care, with reductions in physiotherapy appointments, preoperative visits, hospital days, and face-to-face consultations. Not only would these improvements free up capacity, but they would also result in an estimated saving of 240,540 pound to the trust while reducing the CO2 footprint of knee replacements by 119,381 kg CO2 emitted. A sensitivity analysis revealed that, even with substantial variation of several key variables within the pathway, a trust-wide digital day-case program would still be a cost-saving measure.Conclusions: Overall, the present study supports the growing notion that digital technology can facilitate the transformation of care pathways, resulting in greater efficiency and financial savings for health-care providers while reducing the time patients spend in the hospital.