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The COVID-19 pandemic has led to an unprecedented surgical backlog
As at the end of December 2021, 94,807 patients were on the waiting list for elective surgery in the NSW public health system alone.1
"Although essential, cancellations place a heavy burden on patients and society. Patients' conditions may deteriorate, worsening their quality of life as they wait for rescheduled surgery."
-RAC, press release4
42% of Australians believe that there is still a risk of contracting COVID-19 in a healthcare setting with close to half (49.1%) delaying or cancelling healthcare appointments as a result of this risk.3
Can we ease the burden on hospitals through optimising length of stay?
Clearing the elective surgery backlog is a key priority as health systems enter the recovery phase from COVID-19.
Optimising length of hospital stay is one approach to help address and manage the backlog of orthopaedic surgeries.
Reduced length of hospital stay following joint replacement surgery is associated with improved outcomes
Substantial body of evidence21 shows reduced length of hospital stay is associated with:
| Improved patient satisfaction |
Barker et al. 2006 | 41 Patients | Comparative study of UKR: ERAS (n = 21) vs standard care (n = 20). |
| Husted et al. 2008 | 712 Patients | Comparative study of THR (n = 370) compared with TKR (n = 342). ERAS only. | |
| Husted et al. 2011 | 421 Patients | Comparative study of bilateral TKR (n = 150) compared with unilateral TKR (n = 271). ERAS only. | |
| Larsen et al. 2012 | 157 Patients | Comparative study of TKR and UKR compared with normative population data. ERAS only. | |
| Husted et al. 2010 | 563 Patients | National survey of THR and TKR; outcomes data compared between hospitals with shorter and longer LOS. | |
| Husted et al. 2011 | 29 Patients | Case series of revision knee replacement. ERAS only. | |
| Improved quality of life | Larsen et al. 2012 | 211 Patients | Comparative study of TKR and UKR compared with normative population data. ERAS only. |
| Larsen et al. 2010 | 196 Patients | Comparative study of THR compared with normative population data. ERAS only. | |
| Greater patient acceptance | Hunt et al. 2009 | 35 Patients | Qualitative interviews of primary THR ERAS vs standard care. |
ERAS: Enhanced Recovery After Surgery; LOS: Length of Stay; THR: Total Hip Replacement; TKR: Total Knee Replacement; UKR: Uni-compartmental Knee Replacement.
Changing practice can be challenging. That’s why Johnson & Johnson have developed a variety of solutions to support reduced length of hospital stay.
We’re making a difference for surgeons and hospitals today, so patients can enjoy a healthier tomorrow by:
References
- Bureau of Health Information. New South Wales and the COVID-19 pandemic in 2021. Sydney (NSW); BHI; 2022 pg 53.
- COVIDSurg Collaborative. Br J Surg. 2020;107(11):1440–9.
- Johnson & Johnson Medical Pty Ltd. My Health Can’t Wait Survey. Accessed 2 February 2021.This survey was conducted online by The Online Research Unit on behalf of and fully funded by Johnson & Johnson Medical Pty Ltd in January 2021 among 1,058 Australians aged 18 and older.
- Royal Australasian College of Surgeons. COVID-19 disruption will lead to 28 million surgeries being cancelled worldwide. Press release. 15 May 2020. (Accessed 2 September 2021).
- Sattler L et al. Aust J Gen Pract. 2020;49(9):587–91.
- National Guideline Centre (UK). Evidence review for inpatient hip and knee postoperative rehabilitation: Joint replacement (primary): hip, knee and shoulder: Evidence review P.London: National Institute for Health and Care Excellence (UK); 2020 Jun.
- Canadian Institute for Health Information. Hip and Knee Replacements in Canada: CJRR Annual Statistics Summary, 2018–2019. Ottawa, ON: CIHI; 2020.
- AAOS American Joint Replacement Registry (AJRR): 2021 Annual report.
- Husted H et al. Acta Orthop 2008;79(2):168–73.
- Machin JT et al. Ann R Coll Surg Engl. 2013;95(8):577–81.
- Jones EL et al. Ann R Coll Surg Engl. 2014;96(2):89–94.
- Higgins M et al. Knee. 2020;27(2):469–76
- Garriga C et al. Sci Rep. 2018;8(1):3380
- Sattler L et al. BMC Musculoskelet Disord. 2020;21(1):481.
- Joseph Z et al. J Orthop. 2020;22:543-547.
- Didden AGM et al. Int J Orthop Trauma Nurs. 2019;34:9-15.
- Stambough et al. J Arthroplasty 2015;30:521–6.
- Malviya A et al. Acta Orthop. 2011;82:577–81.
- Jiang HH et al. Orthopaed Surg. 2019;11:229–35.
- Khan SK et al. Acta Orthop. 2014;85:26–31.
- Jones EL et al. Ann R Coll Surg Engl. 2014;96(2):89–94.
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