Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2023; 14(4): 231-239
Published online Apr 18, 2023. doi: 10.5312/wjo.v14.i4.231
Acute hospital-community hospital care bundle for elderly orthopedic surgery patients: A propensity score-matched economic analysis
Ivan En-Howe Tan, Aik Yong Chok, Yun Zhao, Yonghui Chen, Chee Hoe Koo, Junjie Aw, Mave Hean Teng Soh, Chek Hun Foo, Kwok Ann Ang, Emile John Kwong Wei Tan, Andrew Hwee Chye Tan, Marianne Kit Har Au
Ivan En-Howe Tan, Yun Zhao, Yonghui Chen, Mave Hean Teng Soh, Chek Hun Foo, Marianne Kit Har Au, Group Finance, Singapore Health Services, Singapore 168582, Singapore
Aik Yong Chok, Yun Zhao, Chee Hoe Koo, Emile John Kwong Wei Tan, Department of Colorectal Surgery, Singapore General Hospital, Singapore 169608, Singapore
Junjie Aw, Post-Acute and Continuing Care, Family Medicine, Outram Community Hospital, Singapore 168582, Singapore
Kwok Ann Ang, Finance, Singapore General Hospital, Singapore 169608, Singapore
Andrew Hwee Chye Tan, Department of Orthopedic Surgery, Singapore General Hospital, Singapore 169856, Singapore
Marianne Kit Har Au, Singhealth Community Hospital, Singapore 168582, Singapore
Author contributions: Au MKH, Ang KA, Tan AHC, and Tan EJKW conceived and planned the study; Tan IEH and Chok AY supervised the study and wrote the manuscript; Chok AY and Zhao Y performed the analysis and interpreted the results; Chen YH, Soh MHT, and Foo CH collected and verified data; Koo CH and Aw JJ participated in the review of the manuscript; Chok AY, Tan EJKW, and Au MKH provided critical revisions for final approval; all authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by Singapore Health Services (SingHealth) Institutional Review Board (approval No. 2022/2178).
Informed consent statement: Due to the study’s retrospective design using de-identified data, written informed consent collection was waived by SingHealth Centralised Institutional Review Board.
Conflict-of-interest statement: All authors declare that they have no relevant or material financial interests related to the research described in this paper.
Data sharing statement: The data supporting this study’s findings are not publicly available due to privacy and ethical restrictions.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Aik Yong Chok, FRCS (Ed), MBBS, MMed, Surgeon, Department of Colorectal Surgery, Singapore General Hospital, 20 College Road, Singapore 169608, Singapore 169608, Singapore. chokaikyong@gmail.com
Received: January 24, 2023
Peer-review started: January 24, 2023
First decision: February 8, 2023
Revised: February 18, 2023
Accepted: March 27, 2023
Article in press: March 27, 2023
Published online: April 18, 2023
Processing time: 83 Days and 23.2 Hours
Core Tip

Core Tip: This study evaluated the cost-effectiveness of an intervention that bundled Acute Hospital-Community Hospital (AH-CH) care. The AH-CH care bundle intervention effectively reduced AH length of stay (LOS) and costs for elderly patients aged 75 and above undergoing elective orthopedic surgery in Singapore General Hospital. Our findings indicate that systematically transitioning care between AH and CH using this care bundle reduces AH LOS and achieves cost savings. This intervention increases public hospital bed capacity and reduces inpatient hospitalization costs.