Is it feasible to implement a rapid recovery pathway for adolescent idiopathic scoliosis patients undergoing posterior spinal instrumentation and fusion in a single-payer universal health care system?

摘要: PURPOSE The purpose of this project was to determine if it is feasible implement a rapid recovery pathway (RRP) for the surgical treatment adolescent idiopathic scoliosis (AIS) within single-payer universal healthcare system while simultaneously decreasing length stay (LOS) without increasing post-operative complications. METHODS A retrospective analysis completed all patients who underwent posterior spinal fusion AIS at tertiary children's hospital in Canada between March 2010 and February 2019, with date implementation RRP being 1st, 2015. Patient demographic information collected along variety outcome variables including: LOS, wound complication, infection, 30-day return OR, emergency department visit, readmission. An interrupted time series utilized any benefits were associated RRP. RESULTS total 244 identified, 113 conventional 131 No significant differences features or complications found two cohorts (p > 0.05). Using robust linear model, LOS be significantly shorter group, average 5.2 [95% IQR 4.3-6.1] days group 3.4 3.3-3.5] (p < 0.05). CONCLUSION This study shows that possible system. Use can effectively reduce risk developing complication. has upside potential family costs. LEVEL OF EVIDENCE Therapeutic III.