Hospital stay reduced for patients undergoing hip and knee replacements

MedTech News: A short stay in hospital program accompanied by at home care could significantly reduce the burden on the stretched healthcare system struggling to cope with the backlog of elective surgery patients in the public system.

Consulting Economist to KPMG, Craig Emerson, said the report commissioned by Medibank found that a short stay model would significantly reduce pressure on hospitals.

“Across Australia the short stay, no gap pilot program currently offered by Medibank reduced length of stay following a hip and knee replacement by 50% [for low complexity patients],” Dr Emerson said.

The report also found that expansion of the program across the hospital system, in both public and private settings and to include other procedures would save 23,000 bed days in 2023 and 72,000 bed days in 2030. The calculations were under a conservative adoption of just 10% of eligible patients across all modalities.

Dr Emerson said “Given the growing interest in at home care, the savings are expected to be higher at 217,000 bed-days saved in 2030 if the adoption rate increases to 20% in 2025 and 30% in 2030.”

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Medibank Group Executive, CEO Health Services, Dr Andrew Wilson welcomed the findings and called on government and healthcare practitioners to consider new models of care to increase access, choice and control for all Australians.

“Waiting times for elective surgeries in the public system grew substantially in the past year, from 39 to 48 days. Innovation in healthcare delivery models is essential if we are to ensure the sustainability of healthcare in Australia,” Dr Wilson said.

“Our current system is skewed to delivery of services in high-cost hospital settings but with healthcare costs increasing by 3.5% each year, chronic conditions on the rise, an ageing population and hospital staff and resources already stretched, reform is needed. It’s urgent.

“Australia is one of the slowest adopters in the OECD of new care models. A short stay model of care is already widely available at scale in other health systems across a number of modalities, it is essential that we introduce clinically safe, patient-centred models of care now.”

Short stay offers patients high quality care and choice in how their treatment is delivered, minimises unnecessary time in hospital and reduces out-of-pocket costs. Patients are currently paying approximately $1,200 out of pocket for a hip or knee replacement, which is expected to increase to $1,400 by 2030. An expansion of the program would reduce out-of-pocket costs by $10 million in 2023, $18 million in 2025 and $34 million in 2030**.

“Where clinically appropriate this model gives eligible patients the option to recover and rehabilitate in the comfort of their own home, with in-home support by nurses, allied health practitioners and personal carers.”

The KPMG analysis of Medibank’s data supports Medibank’s claims that the program is focussed on putting patients at the centre of treatment, with 78% of surveyed participants favourable toward short stay.

The report also found that there is no significant difference in the probability of having a clinical complication – for low complexity patients – between the short stay pilot program participants and patients receiving conventional care.

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