title: Is longer waiting time associated with health and social services utilization before treatment? A randomized study.
abstract: OBJECTIVE
  To determine whether longer waiting time for major joint replacement is associated with health and social services utilization before treatment.
  
  
  METHODS
  When placed on the waiting list, patients were randomized to short (<or=3 months) or a non-fixed waiting time. Utilization measures were the use of home health care, rehabilitation and social services before treatment.
  
  
  RESULTS
  A total of 833 patients with osteoarthritis of the hip or knee joint were recruited into the study. Six hundred and twenty-two patients were included in the analysis. The majority of patients were not using any services before hospital admission for joint replacement surgery. The most commonly used service was unpaid home help provided by relatives, neighbours, friends and volunteers (informal care). In both groups, private support services were utilized more often than public ones. Patients with a short waiting time were more likely than those with a non-fixed waiting time to use rehabilitation (13.5% versus 8.2%, P=0.032) and visiting care services (7.5% versus 3.9%, P=0.054).
  
  
  CONCLUSIONS
  Only a few patients used professional care. They were more likely to require informal care during the waiting time. A longer waiting time did not result in a higher utilization rate before admission for treatment.
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland. johanna.hirvonen@mikkeliamk.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Hirvonen
authors.forename: Marja
authors.initials: M
authors.lastname: Blom
authors.forename: Ulla
authors.initials: U
authors.lastname: Tuominen
authors.forename: Seppo
authors.initials: S
authors.lastname: Seitsalo
authors.forename: Matti
authors.initials: M
authors.lastname: Lehto
authors.forename: Pekka
authors.initials: P
authors.lastname: Paavolainen
authors.forename: Kalevi
authors.initials: K
authors.lastname: Hietaniemi
authors.forename: Pekka
authors.initials: P
authors.lastname: Rissanen
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005387:Finland; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs; D010003:Osteoarthritis; D012947:Social Work; D014850:Waiting Lists