[The impact of a case management approach for total hip and knee arthroplasty patients].
The primary goal of this research was to evaluate the impact of introducing a case management approach for total hip (THA) and knee (TKA) arthroplasty patients, on the number of complications, visits to the emergency clinic and readmissions, as well as on length of stay (LS). The period covered by this retrospective study was fiscal 1999-2000. Subjects were divided into an experimental group, with the case management, and a control group receiving the usual care. The second goal of the research was to compare these groups with non-equivalent groups from fiscal 1996-1997, before case management was introduced. The reference framework used is the case management model in the institution. All in all, 256 files (52%) were reviewed. We found that the LS, for THA and TKA cases in the hospital where the experiment was done, had decreased considerably three years after case management was introduced, and that this reduction was also significant for TKA cases in comparison with the non-case management group at the control group hospital, without compromising certain clinical results.
Gagnon
Johanne
J
Legendre-Parent
Anne
A
Vigneault
Bernise
B
Marquis
François
F
Paquet
Julien
J
Michaud
Dominique
D
Gauyin
Marie-Claude
MC
D000046:Academic Medical Centers; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000451:nursing* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000451:nursing* / Q000706:statistics & numerical data; D019090:Case Management / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data; D015397:Program Evaluation; D011792:Quebec; D012189:Retrospective Studies