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围手术期外科之家:提高全关节置换术的医疗价值与质量

The Perioperative Surgical Home: Improving the Value and Quality of Care in Total Joint Replacement.

作者信息

Chimento George F, Thomas Leslie C

机构信息

Department of Orthopaedic Surgery, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA, 70121, USA.

Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA.

出版信息

Curr Rev Musculoskelet Med. 2017 Sep;10(3):365-369. doi: 10.1007/s12178-017-9418-3.

Abstract

PURPOSE OF REVIEW

The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH.

RECENT FINDINGS

The PSH model guides the patient throughout the pre and perioperative process and into the postoperative phase. It has been shown in multiple studies to decrease length of stay, improve functional outcomes, allow more home discharges, and lower costs. There is no increase in complications or readmission rates. The PSH pathway is a safe and effective method of providing value-based care to patients undergoing hip and knee arthroplasty.

摘要

综述目的

围手术期外科之家(PSH)是一种以患者为中心、由医生主导的多学科护理路径,旨在基于共同决策提供基于价值的护理。医生和医院的报销将与以较低成本提供高质量护理挂钩,并且PSH模式已用于为接受下肢关节置换术的患者提供护理。本综述的目的是讨论PSH的基本原理、定义、发展、现状和未来方向。

最新发现

PSH模式在术前、围手术期及术后阶段全程指导患者。多项研究表明,它可缩短住院时间、改善功能结局、增加出院回家的人数并降低成本。并发症或再入院率没有增加。PSH路径是为接受髋膝关节置换术的患者提供基于价值护理的一种安全有效的方法。

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本文引用的文献

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How efficient is patient discharge following lower limb arthroplasty?下肢关节置换术后患者的出院效率如何?
Perioper Med (Lond). 2015 Apr 30;4:5. doi: 10.1186/s13741-015-0015-y. eCollection 2015.
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The Financial Impact of a Multidisciplinary Preoperative Risk Stratification Program for Joint Arthroplasty.
J Arthroplasty. 2015 Sep;30(9):1485-91. doi: 10.1016/j.arth.2015.04.014. Epub 2015 Apr 11.

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