[Length of stay in total hip and knee arthroplasty in Danmark I: volume, morbidity, mortality and resource utilization. A national survey in orthopaedic departments in Denmark]

Abstract

Introduction: The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in Denmark in order to focus on the relationship between duration of hospital stay, surgical volume, morbidity and mortality and resources.

Materials and methods: According to the National Register on Patients in 2004 concerning postoperative length of hospital stay, readmissions (30 days) and mortality (30 and 90 days), departments with short and long hospital stay were compared and potential economical savings were estimated if all departments reduced their stays to match the departments with the shortest hospital stay.

Results: Postoperative hospital stay varied between departments from 4.5 to 12 days. Two-thirds of the departments had stays of more than seven days. A high surgical volume tended to correlate with short hospital stay and reduced mortality. A nation-wide reduction of hospital stay after THA and TKA to five days would free 28,000 hospital beds and produce economic savings of approx. 13 million Euro.

Conclusion: Nation-wide implementation of fast-track THA and TKA would result in a significant decrease in the needed number of hospital beds and generate economic savings with similar or better outcome.