Hospitals are the best place to be if you are acutely ill or require surgery but increasingly we are realising they are not the ideal place for recovery or rehabilitation. After extensive studies comparing hospital and home recovery, it seems that home offers certain qualities to the recovery process that you simply can’t get in hospital.
Why is home recovery more effective?
There are a number of reasons that home recovery is deemed more effective. Not least is the fact that people feel happier and more comfortable recovering in familiar surroundings.
In the case of vulnerable patients the risk of Hospital Acquired Infection, institutionalisation and deconditioning (losing physical and cognitive capabilities) is also a consideration. And for hospitals themselves, pressure on beds means that it makes sense for patients to go home as quickly as possible, within the parameters of what is safe and appropriate.
Home recovery following joint replacement
But what about joint replacement surgery? Is this a case where patients need to stay in hospital or a rehabilitation unit until they are physically capable of standing and moving about?
Historically we have always thought so, but more and more doctors and physios are coming round to the opinion that home appears is the very best place for recover from hip and knee replacements.
And this is backed up by some rigorous research studies.
A recent article in The New York Times [1] highlighted this issue in April 2017 and came out firmly in favour of home-based recovery. It was written by Jane E Brody, who had had both knees replaced. She pointed out that patients are often encouraged to postpone joint replacement operations for as long as possible, undergoing other procedures such as injections to manage the symptoms instead.
One of the reasons for postponing surgery is the cost to the health service of surgery and rehab. As here in the UK, there is a drive to minimise cost without compromising the wellbeing of patients. One of the ways of doing this appears to be for patients to go home quicker rather than remaining in hospital for rehabilitation.
Latest research supports home recovery
If you’re awaiting hip or knee replacement, its worth noting that the latest research shows that the overwhelming majority of patients recover equally well at home and may experience fewer complications than if they spend days or weeks in rehab.
Dr Javad Parvizi, Chairman of Research in Orthopaedics at Thomas Jefferson University said:
“We need to re-examine who, if anyone, should go to a rehab facility after joint replacement.”
The results of a new Australia study [2] appear to back this up. Eighty-one patients who had undergone knee replacement were randomly selected to have 10-days of inpatient rehabilitation followed by an eight-week home-based programme.
Eighty-four patients received only the home-based programme and another 87 patients acted as a non-randomised observation group, receiving only home-based rehabilitation. Six months on from surgery, there was no difference in terms of mobility, pain, function or quality of life between those groups who received inpatient rehab compared to those who recovered at home.
When it comes to making a full and comfortable recovery from joint replacement surgery, it seems like there really is no place like home.
