The Financial Impact of a Multidisciplinary Preoperative Risk Stratification Program for Joint Arthroplasty

被引：15

作者：

Duplantier, Neil ^{[1
,3
]}

Briski, David ^{[1
,3
]}

Ochsner, John Lockwood ^{[1
,3
]}

Meyer, Mark ^{[1
,3
]}

Stanga, Daryl ^{[2
]}

Chimento, George F. ^{[1
,3
]}

机构：

[1] Ochsner Hlth Syst, Dept Orthopaed Surg, New Orleans, LA USA

[2] Covington Orthoped Sports Med Inst, Covington, LA USA

[3] Univ Queensland, Sch Med, Ochsner Clin Sch, New Orleans, LA USA

来源：

JOURNAL OF ARTHROPLASTY | 2015年 / 30卷 / 09期

关键词：

arthroplasty; knee; hip; cost; efficiency; standardization; TOTAL KNEE ARTHROPLASTY; HIP; COMORBIDITIES; COMPLICATIONS; COSTS; RATES;

D O I：

10.1016/j.arth.2015.04.014

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

This study's purpose was to assess the impact of a preoperative risk stratification program on joint arthroplasty outcomes at a single institution. We hypothesized that by using a standardized preoperative risk stratification center we would see better outcomes and decreased costs. The triage cohort (T) included 1498 patients assessed at a standardized risk stratification center, and the non-triage cohort (NT) included 1100 patients who did not utilize the center. The T cohort had significantly higher ASA classification (P<0.0001) and ACCI scores (P=0.028). We found no significant difference in complication rates. The T cohort showed a significant decrease in LOS (P<0.0001) and an increase in average reimbursement (P=0.009). A standardized preoperative risk stratification center can contribute to decreased LOS, increased reimbursement and help prevent complications. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：1485 / 1491

页数：7

共 21 条

[1]

American Joint Replacement Registry, 2013 ANN REP

[2] Postoperative Myocardial Infarction and Cardiac Arrest Following Primary Total Knee and Hip Arthroplasty: Rates, Risk Factors, and Time of Occurrence [J].

Belmont, Philip J., Jr. ;

Goodman, Gens P. ;

Kusnezov, Nicholas A. ;

Magee, Charles ;

Bader, Julia O. ;

Waterman, Brian R. ;

Schoenfeld, Andrew J. .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2014, 96A (24) :2025-2031

[3] Thirty-Day Postoperative Complications and Mortality Following Total Knee Arthroplasty [J].

Belmont, Philip J., Jr. ;

Goodman, Gens P. ;

Waterman, Brian R. ;

Bader, Julia O. ;

Schoenfeld, Andrew J. .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2014, 96A (01) :20-26

[4] Resource utilization and costs before and after total joint arthroplasty [J].

Bozic, Kevin J. ;

Stacey, Brett ;

Berger, Ariel ;

Sadosky, Alesia ;

Oster, Gerry .

BMC HEALTH SERVICES RESEARCH, 2012, 12

[5] The Influence of Procedure Volumes and Standardization of Care on Quality and Efficiency in Total Joint Replacement Surgery [J].

Bozic, Kevin J. ;

Maselli, Judith ;

Pekow, Penelope S. ;

Lindenauer, Peter K. ;

Vail, Thomas P. ;

Auerbach, Andrew D. .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2010, 92A (16) :2643-2652

[6]

Carrillo S, 2012, AM SOC AN

[7]

Centers for Disease Control and Prevention, 2013 INP SURG

[8] Comorbidities increase complication rates in patients having arthroplasty [J].

Jain, NB ;

Guller, U ;

Pietrobon, R ;

Bond, TK ;

Higgins, LD .

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2005, (435) :232-238

[9]

Jamsen Esa, 2012, J Bone Joint Surg Am, V94, pe101, DOI 10.2106/JBJS.J.01935

[10] Long-term followup of nonmodular total knee replacements [J].

Keating, EM ;

Meding, JB ;

Faris, PM ;

Ritter, MA .

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2002, (404) :34-39

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