Jeanne M. Huddleston, MD; Kirsten Hall Long, PhD; James M. Naessens, MPH; David Vanness, PhD; Dirk Larson, MS; Robert Trousdale, MD; Matt Plevak, BS; Miguel Cabanela, MD; Duane Ilstrup, MS; Robert M. Wachter, MD; the Hospitalist–Orthopedic Team Trial Investigators
Acknowledgments: The authors thank Donna Lawson, LPN, and Danica Myhre, BS, for data collection, data entry, and project management; Marlené Boyd for administrative assistance; the Department of Medicine leadership, Kevin Whitford, MD, and other Inpatient Internal Medicine faculty and the Department of Orthopedic Surgery for their strong support, participation, and collaboration; the orthopedic surgical nurses at Rochester Methodist Hospital for their willingness to become crucial members of the Hospitalist–Orthopedic Team model of perioperative care; and Amy J. Markowitz for her editorial review.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Jeanne M. Huddleston, MD, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Huddleston, Long, Trousdale, Cabanela, and Naessens, Mr. Larson, Mr. Plevak, and Mr. Ilstrup: Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Dr. Vanness: University of Wisconsin-Madison, 785 WARF Building, 610 Walnut Street, Madison, WI 53726.
Dr. Wachter: University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143.
Huddleston JM, Long KH, Naessens JM, Vanness D, Larson D, Trousdale R, et al. Medical and Surgical Comanagement after Elective Hip and Knee Arthroplasty: A Randomized, Controlled Trial. Ann Intern Med. 2004;141:28-38. doi: 10.7326/0003-4819-141-1-200407060-00012
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Published: Ann Intern Med. 2004;141(1):28-38.
No large studies evaluate potential benefits and costs of internists and surgeons comanaging postoperative patients.
In this single-center trial, high-risk patients undergoing elective hip or total knee arthroplasty were randomly assigned to either standard surgical care or comanagement care by a team of general internal medicine faculty and orthopedic physicians and nurses. Compared with standard care, comanagement care reduced the number of postoperative complications but did not affect overall length of stay or costs. Clinicians strongly preferred comanagement care.
Costs of comanagement were not captured fully because physician–patient interaction time was not tracked.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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