Waiting for hip arthroplasty: economics costs and health outcomes
Fielden, JM, Cumming, JM, Horne, JG, Devane, PA, Slack, A & Gallagher, LM 2005, 'Waiting for hip athroplasty', The Journal of Arthroplasty, vol. 20, no. 8, pp. 990-997.
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This prospective cohort study of 153 patients aimed to determine the economic and health costs of waiting for total hip arthroplasty (THA). Health-related quality of life, using self-completed WOMAC and EQ-5D questionnaires, was assessed monthly from enrolment preoperatively to 6 months postsurgery. Monthly cost diaries were used to record costs. The mean waiting time was 5.1 months and mean total cost of waiting for surgery was NZ$4305 (US$2876) per person (pp) (NZ$1 = US$0.668). Waiting more than 6 months was associated with a higher total mean cost (NZ$4278/US$2858 pp) than waiting less than 6 months (NZ$2828/US$1889 pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P ≤ .01). Waiting longer led to poorer physical function preoperatively (P ≤ .01). Those with poor initial health status showed greater improvement in WOMAC (P = .0001) and EQ-5D (P = .003) measures by 6 months after surgery. Longer waits for total hip arthroplasty incur greater economic costs and deterioration in physical function while waiting.