Abstract
Performance evaluation in specialist orthopaedic hospitals was reviewed in comparison to district general hospitals (DGHs) using a variety of outcome measures, including surgical activity, length of stay and infection rates.
Data regarding admission rates, operations performed or cancelled, outpatient activity and waiting times were obtained from the Hospital Episode Statistics department of the Department of Health. Surgical site infection (SSI) and MRSA infection rates from the Royal National Orthopaedic Hospital (RNOH) are compared to national data supplied by the Health Protection Agency.
In comparison with DGHs, specialist orthopaedic hospitals admit fewer patients, with fewer emergencies; have a higher ratio of waiting list patients to number of patients admitted; have longer waiting list times on average; perform more primary joint arthroplasty surgery; undertake more revision procedures; discharge patients home following joint arthroplasty surgery on average one day earlier; have a lower total hip arthroplasty SSI rate (0.8%) compared with 2.3% in 146 DGHs and from RNOH data, provide a service with a lower surgical site infection and MRSA rate.
Specialist orthopaedic hospitals in England provide a unique, efficient and effective service compared to DGHs. However, short-term performance measures, though simpler to collate, may not be as valuable as longer-term outcome measures, thus making direct comparisons between DGHs, specialist orthopaedic hospitals and independent treatment centres difficult.
