title: Impact of a clinical pathway and implant standardization on total hip arthroplasty: a clinical and economic study of short-term patient outcome.
abstract: This study evaluates the impact of a clinical pathway (CP) and a hip implant standardization program (HISP) on the quality and cost of total hip arthroplasty (THA). Two hundred six unilateral THA operations for osteoarthritis were evaluated: 89 operations were performed in 1991 without a CP or HISP (4-year follow-up period); 117 operations were performed in 1993 with a CP and HISP (2-year follow-up period). All patients had good clinical results and excellent outcomes with short-term follow-up evaluation. No differences were seen between groups in terms of patient ratings of outcome and satisfaction or in terms of complication rates in the hospital. Implementation of a CP and HISP did not adversely affect the short-term outcome of THA but did reduce hospital length of stay and hospital cost for THA.
authors.affiliation: Department of Orthopaedic Surgery, Lahey Hitchcock Medical Center, Burlington, MA 01805, USA.
authors.forename: W L
authors.initials: WL
authors.lastname: Healy
authors.forename: M E
authors.initials: ME
authors.lastname: Ayers
authors.forename: R
authors.initials: R
authors.lastname: Iorio
authors.forename: D A
authors.initials: DA
authors.lastname: Patch
authors.forename: D
authors.initials: D
authors.lastname: Appleby
authors.forename: B A
authors.initials: BA
authors.lastname: Pfeifer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000592:standards*; D019091:Critical Pathways; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D016896:Treatment Outcome