title: The Cost-Utility of Total Hip Arthroplasty: Earlier Intervention, Improved Economics.
abstract: We estimated the cost of Quality-Adjusted-Life-Years gained according to preoperative disease severity. We studied 159 primary unilateral THA, mean follow-up: 4 years. A median split of preoperative WOMAC scores was done to set apart a low (better) and a high (worse) score group. The groups with worse preoperative WOMAC were consistently associated with a less cost-effective intervention. The highest mean cost-effectiveness was achieved by patients with better WOMAC-total ($8256.32/QALY-gained). As patients aged, the cost-effectiveness of THA decreased. Patients 75 years of age or older and with worse scores had the least cost-effective interventions ($25,937.33/QALY-gained). THA remains a very cost-effective intervention even when performed in older "sicker" patients. Waiting for the patient to deteriorate will make the intervention more "expensive".
authors: The Center for Advanced Orthopedics at Larkin Hospital South Miami, Florida.
authors: Carlos J
authors: CJ
authors: Lavernia
authors: The Center for Advanced Orthopedics at Larkin Hospital South Miami, Florida; Arthritis Surgery Research Foundation South Miami, Florida.
authors: David A
authors: DA
authors: Iacobelli
authors: Arthritis Surgery Research Foundation South Miami, Florida.
authors: Larry
authors: L
authors: Brooks
authors: The Center for Advanced Orthopedics at Larkin Hospital South Miami, Florida; Arthritis Surgery Research Foundation South Miami, Florida.
authors: Jesus M
authors: JM
authors: Villa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: QALY; cost-effectiveness; cost–utility analysis; preoperative; quality of life; total hip arthroplasty