No increase in postoperative contacts with the healthcare system following outpatient total hip and knee arthroplasty

Abstract

Background and purpose — Discharge on the day of surgery (DDOS) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) has been shown to be safe in selected patients. Concerns have been raised that discharg- ing patients on the day of surgery (DOS) could lead to an increased burden on other parts of the healthcare system when compared with patients not discharged on the DOS (nDDOS). Therefore, we investigated whether discharging patients on the day of surgery (DOS) after THA and TKA leads to increased contacts with the primary care sector or other departments within the secondary care sector.

Patients and methods — Prospective data on 261 con- secutive patients scheduled for outpatient THA (n = 135) and TKA (n = 126) were collected as part of a previous cohort study. 33% of THA patients and 37% of TKA patients were discharged on the DOS. Readmissions within 3 months after surgery were recorded. Contacts with the discharging depart- ment, other departments, and primary care physicians within 3 weeks were registered.

Results — No statistically significant differences were found when comparing DDOS patients and patients not dis- charged on the DOS (nDDOS) with regard to readmissions, physical contacts with the discharging department, and con- tacts with other departments as well as general practitioners. THA DDOS patients had significantly fewer contacts with the discharging department by telephone than THA nDDOS patients. TKA DDOS patients had significantly more con- tacts with the discharging department by telephone than TKA nDDOS patients.

Interpretation — Patients discharged on the DOS fol- lowing THA or TKA generally have similar postoperative contacts with the healthcare system when compared with patients not discharged on the DOS.