[Economic consequences of accelerated care pathways in total knee-arthroplasty]

The aim of this study was to compare economic costs, readmissions and the use of services in the primary health care sector associated with total knee-arthroplasty (TKA) between a department with accelerated care pathways and two departments with more conventional pathways.

The cost data were collected retrospectively for 2006 for one department with accelerated pathways in TKA with a separate arthroplastic section, one department with more conventional pathways where the TKA patients were admitted together with acute patients and one department with conventional pathways with only elective orthopaedic surgery. We compared readmissions and the use of secondary services in the primary health sector within three months after discharge.

Patient characteristics were comparable in the three departments, but the length of stay was significantly different (4.4 days; 7.2 days and 6.5 days). Savings of DKK 6,248 and DKK 5,229 per patient, respectively, were generated from the accelerated pathway compared with the two more conventional pathways. There was no difference regarding readmissions or use of services from the patients' general practitioner, but fewer visits at a private physiotherapist were used by patients in the accelerated pathway than by patients in the two more conventional pathways.

The study shows that accelerated pathways are cost-saving compared with more conventional pathways.