New Publication Chair Health Economics, Policy and Management

Digital PROM monitoring eases post-operative follow-up after hip and knee surgery

Key message: A digital, PROM-based monitoring program with automated alerts reduces healthcare spending and outpatient utilization in the first year after hip/knee replacement—offering a promising lever to conserve scarce resources.

Background

Health systems face dual pressures: rising demand and a shrinking workforce. Digital monitoring via Patient-Reported Outcome Measures (PROMs) that triggers interventions when abnormalities occur may be a promising approach.

Study & design

Our new publication, PROM-based monitoring and alerts reduce post-surgery healthcare utilization of patients undergoing joint replacement: A secondary analysis of the PROMoting Quality RCT, presents a secondary analysis of the randomized controlled PROMoting Quality trial conducted in nine German hospitals (recruitment 10/2019–12/2020). We analyzed cost data from 546 hip and 492 knee patients (total n=1,038). In addition to standard follow-up, the intervention group received digital PROM monitoring at 1, 3, and 6 months post-op with automatic alerts for clinically relevant deterioration; study nurses contacted patients and, when necessary, provided recommendations.

Results (12-month follow-up)

• Total spending: −7.9% (hip; −€318; p=0.015) and −7.3% (knee; −€387; p=0.053).
• Utilization (hip): significantly fewer physician visits (−1.51; p=0.005), physiotherapy sessions (−1.65; p=0.037), and prescriptions (−2.14; p=0.042).
• Utilization (knee): notably fewer prescriptions (−3.40; p=0.013) and assistive devices (−0.81; p=0.041).

Our hypothesis: The effects likely arise from a “feeling looked-after” effect that reduces reassurance-seeking visits.

Implications for practice & policy

• Resource relief: Structured, digital follow-up can reduce outpatient contacts and dampen costs—especially relevant given impending workforce shortages.
• Scalability: Extrapolated system-level effects for Germany indicate considerable room for efficiency gains in routine care.
• Patient empowerment: Continuous monitoring with a feedback mechanism strengthens patients’ self-management.

Publication

PROM-based monitoring and alerts reduce post-surgery healthcare utilization of patients undergoing joint replacement: A secondary analysis of the PROMoting Quality RCT, The European Journal of Health Economics.

Full text: link.springer.com