Unicondylar knee arthroplasty in the inpatient vs. outpatient setting: Impact on process time

Abstract

Objective: There is a lack of research on the impact of transitioning inpatient procedures to the outpatient setting, specifically on process time. Unicondylar knee arthroplasty (UKA) presents an opportunity for further investigation as it is already in the early stages of transitioning to the outpatient setting.
Methods: This study analyzed the medical records of 1,075 patients who received UKA from a single surgeon (400 in the outpatient setting and 675 in the inpatient setting). Time in Pre-Op, surgery time, and time in post-anesthesia care unit (PACU) were recorded and compared between inpatient and outpatient settings using Ordinary Least Squares Regression models.
Results: Outpatient UKAs outperformed inpatient UKAs across two out of three process time variables even after controlling for comorbidities, social history, demographics, and surgery related characteristics. Actual surgery time was no different between the two settings.
Conclusions: This study demonstrated that UKA performed in the outpatient setting is associated substantial time savings preoperatively and postoperatively compared with cases performed in the inpatient setting. More research is needed to compare other outcome measures such as patient outcomes of UKA between the two settings. Implications beyond time savings should consider supply and human resources costs.