Study of Health System Reveals Good Functional Outcomes for Patients in Bundled Care Model

Bundled care models for total joint arthroplasty (TJA) may be popular with payers and policy makers, but do they work for patients? A new study says yes.

Researchers arrived at their conclusion after tracking TJA episodes in the University of Utah health care system during its switch from a more traditional approach to Medicare’s Bundled Payment Care Improvement (BCPI) model 2. Similar to other bundled care models, the BPCI reimburses providers a set amount for an entire episode of care, from admission to 90 days after the patient is discharged, rather than for specific services provided during care.

The before-and-after pictures focus on functional recovery, based on data from 680 prebundle and 1,216 postbundle patients gathered between 2014 and 2016 (the health system launched the BCPI in July 2015). Researchers used the Activity Measure for Post Acute Care (AMPAC) mobility assessment and the PROMIS Physical Function Computer Adaptive Test (PF-CAT) to track function outcomes. The AMPAC was used at various points during the hospital stay, and the PF-CAT tracked function presurgery and then 2 weeks, 6 weeks, and 12 months afterwards. Results were published in Arthroplasty Today.

Full story at APTA

Neurocognitive Impairment Linked to Worse Outcomes After Total Joint Replacement

People with undiagnosed neurocognitive deficits are undergoing hip and knee replacements at high rates and are more likely to have poorer short-term outcomes after surgery, according to new research led by orthopedic surgeons at NYU Langone Health.

The study of patients who were screened with cognitive assessments prior to undergoing a total joint arthroplasty, or replacement, showed that those who scored worse on the tests were significantly more likely to fail to progress in rehabilitation and to require admission into the intensive care unit (ICU).

“Our data suggest that neurocognitive impairment is highly prevalent in older individuals who are set to undergo total joint replacements, and we suspect that rates may be underestimated nationwide,” says James Slover, MD, an associate professor of orthopedic surgery at NYU School of Medicine, and an attending orthopedic surgeon and clinical site chief at NYU Langone Orthopedic Hospital. “These patients required more hospital resources and progressed more slowly with physical therapy after surgery. Therefore, it is critical that strategies are developed to screen these patients and protocols are put in place to allocate more support to them before and after surgery.”

Full story at Science Newsline

Neurocognitive deficits worsen outcomes for joint replacement surgery, finds study

In the study, patients were screened with cognitive assessments prior to undergoing a total joint arthroplasty, or replacement.

The findings suggested that people with poor assessment scores were less likely to to complete rehabilitation programs successfully and often require admission into the intensive care unit (ICU).

He went on to say: “These patients required more hospital resources and progressed more slowly with physical therapy after surgery. Therefore, it is critical that strategies are developed to screen these patients and protocols are put in place to allocate more support to them before and after surgery.”

Full story at news-medical.net