title: Waiting for hip arthroplasty: economic costs and health outcomes.
abstract: 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 dollars(US 2876 dollars) per person (pp) (NZ 1 dollar = US 0.668 dollar). Waiting more than 6 months was associated with a higher total mean cost (NZ 4278 dollars/US 2858 dollars pp) than waiting less than 6 months (NZ 2828 dollars/US 1889 dollars pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P < or = .01). Waiting longer led to poorer physical function preoperatively (P < or = .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.
authors.affiliation: Division of Orthopaedics, Department of Surgery and Anesthesia, Wellington School of Medicine and Health Sciences, Wellington South, New Zealand. j.m.fielden@massey.ac.nz
authors.forename: Jann M
authors.initials: JM
authors.lastname: Fielden
authors.forename: J M
authors.initials: JM
authors.lastname: Cumming
authors.forename: J G
authors.initials: JG
authors.lastname: Horne
authors.forename: P A
authors.initials: PA
authors.lastname: Devane
authors.forename: A
authors.initials: A
authors.lastname: Slack
authors.forename: L M
authors.initials: LM
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014850:Waiting Lists