Abstract
Funding for the health service is limited and this inevitably leads to rationing. However, the allocation of funding to different specialities and clinical areas often has no rational basis. The aim of this study was to evaluate the health status of patients on the orthopaedic waiting list.
The SF-36 was used as a postal questionnaire and sent to all adult patients on the elective orthopaedic waiting list at our hospital. Demographic data was collected and patients were grouped by intended operation. The health domains of the SF-36 were adjusted for demographic variables and compared to population norms using non-parametric statistical methods.
The SF-36 was sent to 1586 patients and 1155 responded (73%). Analysis was undertaken for hip replacement (n=194), knee replacement (n=291), knee arthroscopy (n=232), foot and ankle (n=147) and cruciate ligament reconstruction (n=46). All diagnostic groups had significantly worse (p< 0.05) scores for all domains of health when compared to population norms. Patients awaiting joint replacement had worse disability (p< 0.001) than other groups, particularly for pain and physical function. Patients over 40 years awaiting arthroscopy had disability approaching these levels and those awaiting ACL reconstruction had poor physical function. In general, patients awaiting foot or ankle surgery had better health than other diagnostic groups but still had significant reductions when compared to normal. Health scores were not related to the Townsend index for social deprivation, indicating equity of access within the health service.
Patients awaiting hip and knee replacement have worse health than others on the waiting list. The SF-36 could be a useful tool if priority on waiting lists were to be determined by pain and disability rather than waiting time.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
