Discover the Same-day Discharge Hip and Knee Arthroplasty pilot programme
The Discovery Same-day Discharge Arthroplasty (SDDA) pilot programme, launched in August 2021, offers several potential benefits where performed for the appropriate patient. The benefits include faster rehabilitation and return to daily activities, improved patient satisfaction and a reduced use of hospital resources. See the pilot findings below.
Hip and knee arthroplasty procedures are among the most common and successful surgeries performed worldwide, and South Africa is no exception.
The COVID-19 pandemic increased the need for orthopaedic surgeons to continue with these elective procedures without stressing inpatient resources needed for COVID-19 patients. Internationally, the hospital length of stay for arthroplasty has decreased from three weeks in 1980 to a few days in 2022. Globally, the trend is to discharge arthroplasty patients on the same calendar day, within four to eight hours after the procedure. It is becoming more important, in the light of the stressors, that patients and surgeons adapt to remain relevant.
Outpatient arthroplasty has several possible advantages for the patient, including faster rehabilitation, improved patient satisfaction and reduced reliance on hospital resources. Recent research has shown that there is no difference in readmission and complications for patients discharged on the same day compared to those with a longer in-hospital stay.
The patient's care and wellbeing after the procedure can in no way be compromised due to the early discharge. This is why patient selection is important, with a strong emphasis on detailed patient education, a clearly defined pathway, a very involved surgical team and social support.
Discovery Health launched a SDDA pilot in August 2021 with a select group of innovative orthopaedic surgeons in Pretoria. The aim of the pilot was to determine what the key success factors are for SDDA in the SA context. The treatment plan aims to track the outcomes of these members, making sure that the initiative continues the Discovery Health value care-based principles.
The pilot has been phenomenally successful with 72% of all pilot Discovery Health Medical Scheme arthroplasty cases (n=173) discharged on the same day. The average age of these members was 62 years, with the majority (55%) being women. All members who had SDDA as part of the pilot managed to return to daily activities three weeks after the procedure. When asked at the six-week follow up, 91% of the members stated that they would go through the same day discharge pathway again.
From a patient-reported outcomes perspective:
- Hip disability and osteoarthritis outcome scores (HOOS) and knee injury and osteoarthritis outcome scores (KOOS) on average showed a 47% improvement at six weeks and over 80% at six months after the procedure.
- Member expectations met (e.g., walking, gardening, cycling, etc.): 72% at six weeks and 83% at six months.
If you are interested in joining the pilot or need more information, email healthpartners@discovery.co.za and we will contact you.