• Gillian R Hunt, Grainne Crealey, Burra V S Murthy, George M Hall, Philippa Constantine, Seamus O'Brien, Janice Dennison, Pauline Keane, David Beverland, Martin C Lynch, and Peter Salmon.
• Division of Clinical Psychology, University of Liverpool, Liverpool.
• Clin Rehabil. 2009 Dec 1;23(12):1067-77.

ObjectiveTo compare outcomes from hip arthroplasty between a surgical unit with a rapid discharge policy and two comparison units to test the hypothesis that the centre with rapid discharge has outcomes that are not inferior to the comparison sites.DesignProspective cohort study.SubjectsConsecutive consenting patients receiving primary hip arthroplasty during 12 months beginning July 2006 in three UK National Health Service surgical units. One has shortened postoperative stay to median three days; one was a new treatment centre with median stay of five days; the third was a traditional unit with median stay of six days (N = 316, 119, 87, respectively).MethodsPatients were assessed preoperatively and six weeks postoperatively. The primary indicator of function was the Oxford Hip Score. Additional secondary measures included further self-report indicators of function and quality of life and health service costs.ResultsPatient outcome in the unit with rapid discharge was not impaired by comparison with the other sites on any measure: Oxford Hip Score decreased from 49 to 27 in the short-stay unit, from 40 to 30 in the treatment centre and from 43 to 32 in the traditional unit. Cost of arthroplasty was least in the short-stay unit, although there was potential for cost savings in each.ConclusionShort postoperative stay after hip arthroplasty can be achieved without intensive patient preparation or post-discharge care and without compromising short-term patient outcome or increasing health care costs. Longer term follow-up is needed.

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