Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.
J Arthroplasty. 2024 Jul;39(7):1663-1670.e1. doi: 10.1016/j.arth.2024.01.015. Epub 2024 Jan 12.
Inpatient total hip and total knee arthroplasty were substantially impacted by the SARS-CoV-2 (COVID-19) pandemic. We sought to characterize the transition of total joint arthroplasty (TJA) to the outpatient setting in 2 large state health systems during this pandemic.
Adult patients who underwent primary elective TJA between January 1, 2016 and December 31, 2020 were retrospectively reviewed using the New York Statewide Planning and Research Cooperative System and California Department of Health Care Access and Information datasets. Yearly inpatient and outpatient case volumes and patient demographics, including age, sex, race, and payer coverage, were recorded. Continuous and categorical variables were compared using descriptive statistics. Significance was set at P < .05.
In New York during 2020, TJA volume decreased 16% because 22,742 fewer inpatient TJAs were performed. Much of this lost volume (46.6%) was offset by a 166% increase in outpatient TJA. In California during 2020, TJA volume decreased 20% because 34,114 fewer inpatient TJAs were performed. Much of this lost volume (37%) was offset by a 47% increase in outpatient TJA.
This present study demonstrates a marked increase in the proportion of TJA being performed on an outpatient basis in both California and New York. In both states, despite a decrease in overall TJA volume in 2020, outpatient TJA volume increased markedly.
Therapeutic Level IV, Retrospective Cohort Study.
新冠疫情（SARS-CoV-2，COVID-19）对住院髋关节和膝关节置换术产生了重大影响。我们旨在描述 2 大州立卫生系统在这一疫情期间，将全关节置换术（TJA）转变为门诊治疗的情况。
使用纽约州规划和研究合作系统及加利福尼亚州卫生保健获取和信息部的数据回顾性分析了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间接受初次择期 TJA 的成年患者。记录了每年的住院和门诊病例量以及患者人口统计学特征，包括年龄、性别、种族和支付者覆盖范围。使用描述性统计数据比较连续和分类变量。P 值<.05 为差异有统计学意义。
2020 年纽约 TJA 量减少了 16%，因为进行的住院 TJA 减少了 22742 例。通过门诊 TJA 增加 166%，弥补了大部分丢失的容量（46.6%）。2020 年加利福尼亚州 TJA 量减少了 20%，因为进行的住院 TJA 减少了 34114 例。通过门诊 TJA 增加 47%，弥补了大部分丢失的容量（37%）。
本研究表明，加利福尼亚州和纽约州的 TJA 中门诊治疗的比例显著增加。在这两个州，尽管 2020 年 TJA 总量下降，但门诊 TJA 量显著增加。
治疗性四级，回顾性队列研究。
