The effect of waiting time on health and quality of life outcomes and costs of medication in hip replacement patients: a randomized clinical trial.
OBJECTIVE
To evaluate the effect of waiting time on health and quality of life outcomes and costs of medication in total hip replacement (THR) patients in a randomized clinical trial.


METHODS
395 THR patients were recruited into the study. When placed on the waiting list, patients were randomized into a short (< or =3 months) or a non-fixed waiting time (NFWT) (>3 months) group. In the final analyses 309 patients (179 women) with a mean age of 65 years were included. Health-related quality of life (HRQoL) (generic 15D), and pain and function (modified Harris Hip Score (HHS)) were calculated when placed on the waiting list, at hospital admission, and at 3 and 12 months postoperatively. The costs of disease-specific medication were calculated at the same measurement points. All analyses were performed using the intention-to-treat (ITT) principal.


RESULTS
Of the recruited patients, 309 (78%) completed the follow-up (short group 140 and non-fixed group 169 patients). The mean waiting time was 74 days in the short and 194 days in the NFWT groups. In the ITT analyses there were no statistically significant differences between the groups in the weekly use and costs of medication, HRQoL or HHS at baseline, at admission, or 3 or 12 months after surgery. The only difference was in total medication costs during the waiting time period, at EUR 83 and 171, respectively.


CONCLUSIONS
The length of the waiting time did not generate different effects on the studied health and quality of life outcomes of the randomized groups. However, those in short waiting time group reached earlier better HRQoL.
National Research and Development Centre for Welfare and Health, Helsinki, Finland. ulla.tuominen@thl.fi
U
U
Tuominen
H
H
Sintonen
J
J
Hirvonen
S
S
Seitsalo
P
P
Paavolainen
M
M
Lehto
K
K
Hietaniemi
M
M
Blom
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000191:economics / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000191:economics* / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000191:economics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D013997:Time Factors; D014850:Waiting Lists