Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2023; 14(3): 123-135
Published online Mar 18, 2023. doi: 10.5312/wjo.v14.i3.123
Rural implementation of the perioperative surgical home: A case-control study
Srinivasan Sridhar, Amy Mouat-Hunter, Bernadette McCrory
Srinivasan Sridhar, Center for Health Outcomes and Policy Evaluation, College of Public Health, The Ohio State University, Columbus, OH 43210, United States
Amy Mouat-Hunter, Preanesthesia Clinic, Bozeman Health, Bozeman, MT 59715, United States
Bernadette McCrory, Mechanical and Industrial Engineering, Montana State University, Bozeman, MT 59715, United States
Author contributions: Sridhar S performed the experiment, data curation, methodology, and writing the original draft; Mouat-Hunter A was responsible for project administration, validation, review and editing; McCrory B assisted in funding acquisition, project administration, supervision, review and editing.
Supported by Montana Healthcare Foundation, No. 21467213.
Institutional review board statement: This retrospective analysis was approved by the Montana State University Institutional Review Board (Approval# BM050819-EX).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no possible interest on the title page, including financial, consultant, institutional and other relationships that might lead to bias or a conflict of interest.
Data sharing statement: Data cannot be shared publicly because of HIPAA regulations. Data are available from the Bozeman Health (contact via phone or email) for researchers who meet the criteria for access to confidential data. The data underlying the results presented in the study are available from Bozeman Deaconess Hospital - (https://www.bozemanhealth.org/).
STROBE statement: The guidelines of the STROBE statement have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Srinivasan Sridhar, PhD, Center for Health Outcomes and Policy Evaluation, College of Public Health, The Ohio State University, 1841 Neil Avenue, Cunz Hall, Columbus OH 43210, United States. sridhar.96@osu.edu
Received: August 25, 2022
Peer-review started: August 25, 2022
First decision: December 26, 2022
Revised: January 1, 2023
Accepted: February 15, 2023
Article in press: February 15, 2023
Published online: March 18, 2023
Processing time: 203 Days and 16.2 Hours
Core Tip

Core Tip: The study evaluated the newly implemented perioperative surgical home (PSH) at a rural community hospital using a case-control design. With limited supporting microsystems, team-based physician co-management was vital to establish the PSH system and following protocols including preoperative assessment, patient education, and longitudinal digital engagement. The surgical outcomes - length of stay, discharge disposition, and 90-d readmission - were compared between the PSH cohort and the control cohorts. The results from this study highlighted the effectiveness of PSH in improving total joint replacement surgical outcomes, especially for high-risk patients who are older and have one or more medical complications.