Length of Stay and Achievement of Functional Milestones in a Rural First Nations Population in Northwestern Ontario during Acute-Care Admission after Total Hip Replacement: A Retrospective Chart Review.

PURPOSE To understand the postoperative acute-care physiotherapy course for First Nations people returning after total hip replacement (THR) to remote communities with limited rehabilitation services and to evaluate length of stay and attainment of functional milestones after THR to determine to what extent an urban-based clinical pathway is transferrable to and effective for First Nations patients in a rural setting. METHODS Data were collected retrospectively by reviewing charts of patients who underwent THR in the Northwest Ontario catchment area from 2007 through 2012. RESULTS For the 36 patient charts reviewed, median length of stay (LOS) at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) was 7.5 days (range 2-335); median LOS from time of surgery at the regional hospital (Thunder Bay Regional Health Centre) to discharge from SLMHC was 13.5 days; and median time for mobilizing and stairs was 9 days (range 1-93). CONCLUSION Commonly accepted urban clinical pathways are not a good fit for smaller rural hospitals from which First Nations patients return to remote communities without rehabilitation services. LOS in a rural acute-care facility is similar to LOS in an urban rehabilitation facility.

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