Maidment Zoe L, Hordacre Brenton G, Barr Christopher J
Queensland Health, Bundaberg Hospital, Bourbong Street, Bundaberg, Qld 4670, Australia. Email:
Flinders University, Department of Rehabilitation and Aged Care, Repatriation General Hospital, Daws Road, Daw Park, SA 5041, Australia. Email:
Aust Health Rev. 2014 Jun;38(3):265-70. doi: 10.1071/AH13232.
The aim of the present study was to investigate a change in physiotherapy provision from a 5- to 7-days-a-week service on both physiotherapy and hospital length of stay (LOS) after total knee (TKR) and total hip (THR) replacement.
A retrospective analysis of a clinical database was conducted for patients who received either a TKR or THR between July 2010 and June 2012 in one regional hospital.
There was a significant decrease in physiotherapy LOS from 5.0 days (interquartile range (IQR) 5.0-6.0 days) for a 5-day physiotherapy service, to 5.0 days (IQR 4.0-5.0 days) for 7-day physiotherapy service (U=1443.5, z=-4.62, P=0.001). However, hospital LOS was not reduced (P=0.110). For TKR, physiotherapy LOS decreased significantly by 1 day with a 7-day physiotherapy service (U=518.0, z=-4.20, P=0.001). However, hospital LOS was again no different (P=0.309). For THR there was no difference in physiotherapy LOS (P=0.060) or hospital LOS (P=0.303) between the 5- and 7-day physiotherapy services. Where physiotherapy LOS was less than hospital LOS, delayed discharge was due primarily to non-medical issues (72%) associated with hospital organisational aspects.
Increasing the provision of physiotherapy service after TKR provides an increase in physiotherapy sessions and has the potential to reduce hospital LOS. To be effective this must align with other administrative aspects of hospital discharge.
本研究旨在调查全膝关节置换术（TKR）和全髋关节置换术（THR）后，物理治疗服务从每周5天改为每周7天对物理治疗时长和住院时长（LOS）的影响。
对2010年7月至2012年6月期间在一家地区医院接受TKR或THR的患者的临床数据库进行回顾性分析。
物理治疗时长显著减少，从每周5天物理治疗服务的5.0天（四分位间距（IQR）5.0 - 6.0天）降至每周7天物理治疗服务的5.0天（IQR 4.0 - 5.0天）（U = 1443.5，z = -4.62，P = 0.001）。然而，住院时长并未缩短（P = 0.110）。对于TKR，每周7天物理治疗服务使物理治疗时长显著减少1天（U = 518.0，z = -4.20，P = 0.001）。然而，住院时长同样没有差异（P = 0.309）。对于THR，每周5天和每周7天物理治疗服务在物理治疗时长（P = 0.060）或住院时长（P = 0.303）方面没有差异。当物理治疗时长少于住院时长时，延迟出院主要是由于与医院组织方面相关的非医疗问题（72%）。
增加TKR后的物理治疗服务提供量可增加物理治疗疗程，并有可能缩短住院时长。要使其有效，这必须与医院出院的其他管理方面保持一致。
