Table 1.
Comparison of Donabedian indicators for the management of hip replacement surgery among the 12 Belgian hospitals in the study
| Hospitals | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |
| Structure | Number of stays* | 109 | 92 | 47 | 108 | 376 | 113 | 639 | 183 | 251 | 179 | 184 | 130 |
| Gender (%) | |||||||||||||
| Female | 59.63 | 58.7 | 57.4 | 61.1 | 61.4 | 55.8 | 56.5 | 58.5 | 59.0 | 55.9 | 63.0 | 74.6 | |
| Male | 40.4 | 41.3 | 42.3 | 38.9 | 38.6 | 44.2 | 43.5 | 41.5 | 41.0 | 44.1 | 37.0 | 25.4 | |
| Diagnostic type (%) | |||||||||||||
| Chronic | 63.3 | 67.4 | 72.3 | 66.7 | 71.0 | 78.8 | 87.2 | 81.4 | 80.1 | 81.6 | 61.4 | 61.5 | |
| Traumatology | 36.7 | 32.6 | 27.7 | 33.3 | 29.0 | 21.2 | 12.8 | 18.6 | 19.9 | 18.4 | 38.6 | 38.5 | |
| Age* average (SD) | 69.9 (14) |
71.9 (14.6) |
63.9 (15.4) |
70.6 (11.9) |
68.7 (16.1) |
68.3 (14) |
69.7 (11.5) |
67.8 (12.7) |
69.1 (13.1) |
69.8 (12.8) |
73.5 (13.2) |
73.7 (13.2) |
|
| Charlson average* (SD) | 1.02 (1.48) |
1.02 (1.42) |
0.85 (2.32) |
0.93 (1.62) |
0.67 (1.24) |
0.64 (1.02) |
0.56 (1.03) |
0.84 (1.41) |
0.58 (0.99) |
0.62 (1.03) |
0.61 (1.19) |
0.75 (1.32) |
|
| Process | Number of days between admission day and operating day (day)* average (SD) | 1.6 (1.9) |
1.7 (3.3) |
1.4 (2.6) |
2.2 (4.5) |
1.1 (1.2) |
1.2 (1) |
1.1 (0.9) |
1 (2) |
0.5 (1.12) |
0.3 (0.9) |
0.8 (1.5) |
1.5 (1.6) |
| Chronic* average (SD) | 1.1 (0.34) |
1.1 (0.65) |
0.7 (2.4) |
0.5 (0.6) |
1 (0.9) |
1 (0) |
0.9 (0.6) |
0.5 (0.5) |
0.2 (0.6) |
0.2 (0.7) |
0.3 (1) |
1 (0.7) |
|
| Trauma* average (SD) | 2.6 (2.8) |
2.9 (5.6) |
3 (2.4) |
5.4 (6.6) |
1.2 (2.3) |
1.8 (1.9) |
1.9 (1.7) |
3.1 (4) |
1.9 (1.5) |
1 (1.5) |
1.7 (1.8) |
2.3 (2.1) |
|
| Length of stay (without revalidation) average (SD) | 11.6 (8.8) |
8.3 (5.1) |
9.5 (6.9) |
9.8 (8.5) |
6.5 (4.3) |
7.6 (5.4) |
5.1 (3.7) |
6.7 (5.43) |
6.9 (5.9) |
6.2 (4.2) |
8.9 (5.8) |
9 (4.6) |
|
| Length of stay in surgical care unit* average (SD) | 11.3 (8) |
7.8 (4.9) |
7.7 (5.2) |
6.4 (6.9) |
6.3 (3.1) |
6.7 (3) |
4.8 (3.3) |
6.5 (4.8) |
6 (3) |
6 (4) |
7.5 (4.6) |
8.8 (4.5) |
|
| Geriatric | |||||||||||||
| Inpatient geriatric liaison (%) | 13.76 | 25.00 | 17.02 | 27.78 | 10.37 | 17.7 | 0.47 | 6.56 | 2.79 | 0.00 | 24.46 | 0.00 | |
| Geriatric care unit (%) | 1.83 | 4.35 | 10.64 | 17.59 | 0.8 | 4.42 | 2.19 | 0.55 | 5.18 | 1.68 | 8.7 | 2.31 | |
| Length of stay in geriatric care unit* average (SD) | 21 (28.3) |
11 (7.4) |
17.6 (7.2) |
19.3 (8) |
26.3 (30.3) |
20.4 (7.8) |
13.9 (7.9) |
29 (-) |
19.5 (11) |
12.3 (6) |
16.1 (7.1) |
6.7 (6) |
|
| Intensive care unit (%) | 4.58% | 14.13 | 4.26 | 1.85 | 1.33 | 1.76 | 1.41 | 0.55 | 1.99 | 2.23 | 3.26 | 9.23 | |
| Physiotherapy session | |||||||||||||
| After the operation (%) | 88.99 | 96.74 | 100.00 | 65.74 | 9.31 | 98.23 | 68.08 | 99.45 | 99.6 | 96.09 | 96.74 | 15.38 | |
| Number of days between first intervention and first physiotherapy session* average (SD) | 2.2 (1.6) |
1 (0.6) |
1.1 (0.4) |
1.5 (4.2) |
2.1 (1.6) |
1.3 (1.3) |
1.5 (1.4) |
1 (0.4) |
1.1 (0.4) |
1.3 (1.1) |
0.9 (1.1) |
4.4 (3.4) |
|
| Outcomes 1 | Complication (%) | 11.93 | 14.13 | 4.26 | 7.41 | 2.93 | 10.62 | 2.66 | 14.21 | 3.98 | 8.38 | 14.67 | 10.00 |
| Postoperative respiratory failure (%) | 0.92 | 1.09 | 0.00 | 0.00 | 0.53 | 1.77 | 0.16 | 0.00 | 0.00 | 0.56 | 0.00 | 0.77 | |
| Perioperative haemorrhage or haematoma (%) | 8.26 | 8.7 | 2.13 | 2.78 | 1.06 | 6.19 | 0.78 | 12.02 | 1.99 | 4.47 | 5.43 | 3.85 | |
| Infection (%) | 1.83 | 5.43 | 2.13 | 2.78 | 0.53 | 1.77 | 1.25 | 1.64 | 1.99 | 3.91 | 7.61 | 3.08 | |
| Pressure ulcer (III or IV) (%) | 0.92 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.63 | 0.55 | 0.4 | 0.00 | 3.26 | 0.00 | |
| Perioperative pulmonary embolism or deep venous thrombosis (%) | 0.92 | 0.00 | 0.00 | 0.93 | 0.00 | 0.00 | 0.31 | 0.00 | 0.00 | 0.00 | 0.54 | 0.77 | |
| Sepsis (%) | 1.83 | 0.00 | 0.00 | 0.00 | 0.00 | 0.88 | 0.00 | 0.00 | 0.00 | 0.56 | 0.54 | 0.00 | |
| Postoperative physiologic and metabolic derangement (%) | 2.75 | 2.17 | 2.13 | 0.93 | 0.53 | 3.54 | 0.31 | 0.55 | 0.4 | 0.56 | 0.00 | 2.31 | |
| Transfusion reaction (%) | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.4 | 0.00 | 0.00 | 0.00 | |
| Iatrogenic pneumothorax (%) | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| Outcomes 2 | Case mix index average* | 1.69 (0.29) |
1.72 (0.43) |
1.66 (0.22) |
1.78 (0.31) |
1.71 (0.36) |
1.71 (0.40) |
1.67 (0.22) |
1.65 (0.18) |
1.64 (0.26) |
1.68 (0.28) |
1.77 (0.43) |
1.7 (0.45) |
| Mortality* (%) | 1.83 | 4.35 | 0.00 | 1.85 | 1.06 | 2.65 | 0.31 | 0.00 | 1.2 | 1.12 | 1.63 | 3.08 | |
| Readmission <30 days (11 months) | |||||||||||||
| Total readmissions (%) | 6.42 | 11.96 | 2.13 | 12.04 | 5.85 | 3.54 | 3.29 | 8.2 | 4.78 | 5.59 | 7.61 | 3.85 | |
| Readmissions related to arthroplasty (%) | 2.75 | 8.7 | 0.00 | 8.33 | 3.99 | 3.54 | 2.19 | 6.01 | 3.19 | 4.47 | 2.72 | 0.77 | |
| Mortality following readmission* (%) | 14.29 | 18.18 | 0.00 | 4.76 | 0.00 | 0.00 | 0.00 | 8.33 | 10.00 | 7.14 | 0.00 | 0.00 | |
| DALY-cost | DALY (YLL + YLD) total | 17.64 | 40.06 | 0.03 | 14.00 | 27.52 | 30.8 | 14.3 | 0.73 | 25.37 | 38.6 | 18.36 | 19.11 |
| DALY (YLL + YLD)* average (SD) | 0.162 | 0.435 | 0.001 | 0.13 | 0.073 | 0.273 | 0.022 | 0.004 | 0.101 | 0.216 | 0.1 | 0.147 | |
| 0.941 | 1.855 | 0.003 | 0.933 | 0.643 | 1.766 | 0.373 | 0.022 | 0.785 | 2.192 | 0.625 | 0.842 | ||
| Total average cost excluding revalidation* (SD) | €11 137 (€7778) |
€10 246 (€4003) |
€7828 (€3538) |
€9099 (€4465) |
€8322 (€3492) |
€9027 (€4357) |
€7078 (€1795) |
€8343 (€2389) |
€6413 (€3540) |
€7634 (€8379) |
€7943 (€3260) |
€9052 (€5126) |
|
| Total average cost including cost of readmission (excluding revalidation)* (SD) | €11 506 (€7937) |
€12 241 (€9557) |
€7935 (€3790) |
€9982 (€5990) |
€8799 (€4337) |
€9276 (€4603) |
€7210 (€2086) |
€8898 (€3416) |
€6693 (€4209) |
€8049 (€8760) |
€8391 (€4130) |
€9326 (€5323) |
|
*Kruskal-Wallis = p>0.05.
DALYs, disability-adjusted life years; YLD, years lost due to disability; YLL, years of life lost.