Abstract
Introduction: Long waits for total hip joint replacement (THJR) surgery affect quality of life and are likely to impose significant medical, personal and other costs on individuals and society.
Aim: To define the economic and health costs of waiting for THJR surgery.
Method: A prospective study of 130 patients requiring primary THJR is being undertaken. Data on health related quality of life (HRQL), using self completed EQ-5D and WOMAC questionnaires, are collected on enrolment, and every month before surgery and continuing for six months after surgery. Monthly cost diaries are used to record medical, personal and other costs. Inferential statistics and regression analyses will be used to test the strength of associations between costs and waiting times, and changes in HRQL before and after surgery.
Results: Preliminary results indicate that costs are greatest before surgery (mean=$70.41 per person, per month), remain high during the first month after surgery (mean=$53.24 pp pm), and drop significantly (p< 0.05) within six months after surgery (mean=$12 pp pm). WOMAC scores of pain, stiffness and physical function show significant improvements (p< 0.05) within three months after surgery. The EQ-5D also indicated significant (p< 0.05) positive changes.
Conclusions: The preliminary results suggested that patients had high dependency levels for the first month after surgery. Consequently, costs associated with recuperation after surgery may have shifted from the public hospitals onto the community and family. Significant improvements in HRQL by three months after surgery indicated that THJR is a successful intervention for osteoarthritis.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
