Resumen de The efficacy of pre-operative home visits for total hip replacement clients
Annette Rivard, Sharon Warren, Don Voaklander, Allison Jones
- English
Background. There is increasing realization among health care administrative decision makers and service providers that we must measure the true value of expensive services by demonstrating the achievement of identified goals. Purpose. The objective of this study was to determine whether clients who received the home-based intervention for a hip arthroplasty would result in a more timely discharge home from hospital. Method. Two hundred and eight clients receiving a total hip replacement at two acute care hospitals comprised the sample. One hospital included the more costly home-based pre-operative teaching by an occupational therapist as part of its protocol while the other provided comparative occupational therapy intervention within its hospital based pre-admission clinic. Discharge disposition and length of hospital stay were measured. Results. Though no significant difference in either of these outcomes was found, a number of issues were raised indicating the complexity of resource allocation to this client population and the importance of the qualitative dimensions of care. Practice Implications. The location for pre-operative teaching for total hip replacements was not found to impact the length of hospital stay nor whether clients are discharged directly home.
- français
Description generale. Les decideurs administratifs et les fournisseurs de services du secteur de la sante reconnaissent de plus en plus l'importance de mesurer la valeur reelle des services a couts eleves en donnant des preuves de l'atteinte des objectifs cibles. But. L'objectif de cette etude etait de determiner si des clients ayant eu une intervention a domicile preparatoire a une arthroplastie de la hanche recevraient leur conge plus rapidement de l'hopital. Methodologie. L'echantillon de l'etude etait compose de 208 clients ayant subi un remplacement total de la hanche a deux hopitaux de soins de courte duree. Le protocole de l'un des hopitaux comportait le programme d'education pre-operatoire a domicile le plus couteux, offert par un ergotherapeute, alors que l'autre hopital offrait une consultation pre-admission comparable en ergotherapie, dans l'etablissement. La condition du client lors du conge et la duree de sejour ont ete mesurees. Resultats. Bien qu'aucune difference significative n'ait ete observee dans les resultats, quelques questions ont ete soulevees, mettant en relief la complexite de l'affectation des ressources a cette clientele et l'importance des dimensions qualitatives des soins. Consequences pour la pratique. D'apres les resultats de l'etude, le lieu ou l'enseignement pre-operatoire est prodigue n'a pas d'effet sur la duree du sejour a l'hopital ou sur le retour des clients a domicile.
