Significant Variation Exists in Home Care Services Following Total Joint Arthroplasty

NIZAR N. MAHOMED, JOHNNY T.C. LAU, MANFRED KOO SEEN LIN, RADOVAN ZDERO, and J. RODERICK DAVEY

ABSTRACT.

Objective. To determine a preliminary profile of the variation in rehabilitation and home care services for patients with total joint arthroplasty (TJA) in Ontario in 2001.

Methods. A cross-sectional survey was conducted of directors at the 43 regional community care access centers (CCAC).

Results. One-third (36%) of CCAC had existing care pathways, 54% had defined discharge criteria, and 32% had predetermined the length of home care services. The intensity and frequency of services provided were variable.

Conclusion. There is a need to standardize rehabilitation protocols to maintain quality of care and contain costs. (J Rheumatol 2004;31:973-5)

Key Indexing Terms:

ARTHROPLASTY
TOTAL JOINT ARTHROPLASTY
CARE PATHWAY
HOME CARE

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From the Division of Orthopaedic Surgery, Musculoskeletal Health and Arthritis Program; and the Lower Extremity Arthritis Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.

N.N. Mahomed, MD, ScD, FRCSC, Director; J.T.C. Lau, MD, MSc, FRCSC; J.R. Davey, MD, FRCSC, Division of Orthopaedic Surgery, Musculoskeletal Health and Arthritis Program; M.K.S. Lin, MD, MSc, MBA; R. Zdero, PhD, Lower Extremity Arthritis Program.

Address reprint requests to Dr. N. Mahomed, Musculoskeletal Health and Arthritis Program, Toronto Western Hospital, ECW 1-002, 399 Bathurst Street, Toronto, Ontario M5T 2S8. E-mail: nizar.mahomed@uhn.on.ca

Submitted March 10, 2003; revision accepted November 13, 2003.

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