A Decision Support System on Postoperative Care Management of Total Joint Replacement Patients Using Clinical Outcome Measurement

초록

The postoperative care of total joint replacement patients is of interest to healthcare practitioners due to the high number of annual replacements and growing economic burden on the U.S. healthcare system. Minimizing postoperative care costs and maximizing patients' functional outcomes are the key aspects of postoperative care management. In this paper, a novel analytical framework is introduced in which multiple measurements are concurrently utilized to dynamically assess the recovery progress of the patients, and furthermore, be used as a tool to devise personalized post-discharge intervention plans for the patients. A Markov decision process model is formulated to provide decision support on determining cost-effective intervention care plans that can be used as clinical guidelines in practice. The results clearly demonstrate the risk of using a single measurement method which may lead to inadequate level of intervention, and justifies the need of such modeling based approaches for devising the most appropriate care levels especially in the early recovery periods.

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