Effects of reducing physical therapy services on outcomes in total joint arthroplasty.
A natural experiment provided an opportunity to determine whether physical therapy (PT) service reduction would affect the outcomes of total joint arthroplasty. A sample of 200 patients with rheumatoid arthritis or osteoarthritis who underwent total hip or total knee replacement during successive reduction of services was randomly selected. The demographic and clinical characteristics of patients in each period were similar. Despite large differences between groups in hours of PT per patient, there were no major differences in length of stay between the groups, or compared to similar hospitals, functional status at discharge, or numbers of surgical complications. Implications for health services organization are discussed.
Department of Rheumatology/Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
M H
MH
Liang
K E
KE
Cullen
M G
MG
Larson
J A
JA
Schwartz
C
C
Robb-Nicholson
A H
AH
Fossel
N
N
Roberge
R
R
Poss
D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery; D001900:Boston; D005260:Female; D006622:Hip Prosthesis / Q000534:rehabilitation; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D007595:Joint Prosthesis / Q000534:rehabilitation*; D007720:Knee Prosthesis / Q000534:rehabilitation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D010814:Physical Therapy Department, Hospital / Q000706:statistics & numerical data*; D011183:Postoperative Complications