Edwards Paul K, Mears Simon C, Lowry Barnes C
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 531, Little Rock, AR, 72205, USA.
Curr Rev Musculoskelet Med. 2017 Sep;10(3):356-364. doi: 10.1007/s12178-017-9417-4.
Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals.
Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery. As a result, comprehensive clinical pathways incorporating a preoperative education program for elective hip and knee replacement lead to lower hospital length of stay, higher home discharge, lower readmission, and improved cost. In summary, we report convincing evidence that preoperative education classes are an essential element to successful participation in alternative payment models such as the Bundle Payment Care Initiative.
参与替代支付模式促使人们努力改善治疗效果和患者满意度，同时降低择期髋关节和膝关节置换手术的成本。本综述的目的是确定择期髋关节和膝关节置换手术的术前教育课程是否能实现这些目标。
近期文献表明，术前参加教育课程的患者焦虑感降低，术后疼痛控制更好，对手术的期望更现实，对手术的理解也更好。因此，纳入择期髋关节和膝关节置换术前教育计划的综合临床路径可缩短住院时间、提高出院回家比例、降低再入院率并降低成本。总之，我们报告了令人信服的证据，即术前教育课程是成功参与替代支付模式（如捆绑支付护理计划）的关键要素。
