Joint replacement treatment: Using clinical pathways works

July 1, 2009

Clinical pathways have been used in surgeries since the 1980s, but their nature and usefulness are still subjects of much debate, especially as procedures such as hip and knee joint replacement represent a significant cost to hospitals. Now authors publishing in the open access journal BMC Medicine have concluded that using clinical pathways can effectively improve the quality of the care provided to patients undergoing joint replacement.

A research team from the University of Eastern Piedmont, the Catholic University Leuven, the University Politecnica delle Marche and the Sainte Rita Hospital Trust searched four databases (Medline, Cinahl, Embase and the Cochrane Central Register of Controlled Trials) using relevant medical subject headings. The authors compared trials that contrasted the clinical pathways care with standard medical care whilst analysing at least one of the four possible clinical outcomes of postoperative complications, discharge to home, length of in-hospital stay (LOS) and direct costs.

The meta-analysis, covering 6,316 patients, showed that patients in the clinical pathways group had significantly lower levels of postoperative complications and significantly shorter hospital stays, which greatly contributed to lower hospital costs. The authors believe that these positive findings are a consequence of the care being better organised. Inappropriate care lengthens hospital stays and increases the risk of complications; clinical pathways have been shown to prevent inappropriate care and, thus, the cost to the .

This new data provides policy makers with the evidence they need to evaluate the place of clinical pathways in JR. According to the authors, "With the need for knee and hip joint replacement on the rise, the use of clinical pathways might contribute to better quality of care and cost-effectiveness."

More information: Effects of clinical pathways in the : a meta-analysis, A Barbieri, K Vanhaecht, P Van Herck, W Sermeus, F Faggiano, S Marchisio and M Panella, BMC Medicine (in press), http://www.biomedcentral.com/bmcmed/

Source: BioMed Central (news : web)

Explore further: 'Shrug off' shoulder surgery myth, study suggests

Related Stories

'Shrug off' shoulder surgery myth, study suggests

March 26, 2007

Contrary to widespread belief, total surgical replacement of arthritic shoulder joints carries no greater risk of complications than replacement of other major joints, a Johns Hopkins study suggests.

How often do hip and knee replacements need revision?

September 2, 2008

A comprehensive study using nationwide data on hip and knee replacements in England has found that one in seventy-five patients require a revision of their joint replacement after three years. Although this compares favourably ...

Recommended for you

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...

Quantum Theory May Explain Wishful Thinking

April 14, 2009

(PhysOrg.com) -- Humans don’t always make the most rational decisions. As studies have shown, even when logic and reasoning point in one direction, sometimes we chose the opposite route, motivated by personal bias or simply ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.