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Comparison of Two Home Care Protocols for Total Joint Replacement
Author(s) -
Weaver Frances M.,
Hughes Susan L.,
Almagor Orit,
Wixson Richard,
Manheim Larry,
Fulton Bradley,
Singer Ruth
Publication year - 2003
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2003.51162.x
Subject(s) - medicine , protocol (science) , home health , quality of life (healthcare) , health care , patient satisfaction , physical therapy , randomized controlled trial , nursing , surgery , alternative medicine , pathology , economics , economic growth
OBJECTIVES: To examine the effect of a more‐efficient home care protocol to manage total joint replacement (TJR) patients after surgery. DESIGN: A randomized trial of two home care protocols for TJR management. SETTING: A hospital‐affiliated home healthcare agency in a large midwestern city. PARTICIPANTS: Medicare‐eligible individuals undergoing elective total hip or knee replacement surgery (N = 136). INTERVENTION: A home care protocol that included preoperative home visits by a nurse and a physical therapist and fewer postoperative visits (range of 9–12 visits) to the home than an existing protocol (range of 11–47 visits). MEASUREMENTS: Functional status, lower extremity functioning, health‐related quality of life, satisfaction with care, and use and cost of healthcare services for 6 months postsurgery. RESULTS: There were no differences in functional status, health‐related quality of life, or lower extremity functioning by group at 6 months. A marginally significant gain in satisfaction with access to care ( P = .059) was found in the intervention group at 6 months. Home healthcare costs were 55% lower for the streamlined group ( P < .001). Other costs did not differ significantly by group. CONCLUSION: TJR patients who received the more‐efficient home care protocol experienced comparable outcomes to those who received the existing protocol. An abbreviated set of home care visits resulted in more‐efficient delivery of care without compromising patient outcomes.