This case study follows the 5-step process for accessing and using evidence in response to a request from commissioners to support the work of the Musculoskeletal (MSK) programme.
Using PICO, the scope of the evidence search was defined as:
Population: Adults who have had knee or hip arthroplasty
Intervention: Hospital at Home (HaH)
Comparison: Usual care
Outcomes: Clinical-effectiveness, cost-effectiveness, societal outcomes
A Clinical Effectiveness Programme Officer was asked to conduct the search and report findings.
The following search question was addressed:
“What is the evidence for hospital at home following knee and hip arthroplasty?”
The search strategy involved searching the following databases and websites:
The following search strategy was used:
(“hospital at home”) AND (knee OR hip) AND (arthroplasty* OR replacement)
The evidence-base for this subject is limited. 5 articles were identified, including a systematic review on HaH in facilitating early discharge for elective orthopaedic surgery, among other conditions.
Findings were reported in an evidence review. All papers included in this review suggest that HaH and inpatient care for those recovering from knee or hip arthroplasty are equally effective in terms of clinical outcomes. However, there is insufficient evidence to determine cost-effectiveness.
The findings of the review were consolidated into an evidence review. To promote sharing of learning, this review was uploaded to AHSN’s Evidence Repository on the Futures NHS platform.