Fielden Jann M, Cumming J M, Horne J G, Devane P A, Slack A, Gallagher L M
Division of Orthopaedics, Department of Surgery and Anesthesia, Wellington School of Medicine and Health Sciences, Wellington South, New Zealand.
J Arthroplasty. 2005 Dec;20(8):990-7. doi: 10.1016/j.arth.2004.12.060.
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.
这项针对153名患者的前瞻性队列研究旨在确定等待全髋关节置换术(THA)的经济成本和健康成本。使用患者自行填写的WOMAC和EQ-5D问卷,从术前登记到术后6个月每月评估与健康相关的生活质量。使用每月成本日记记录成本。平均等待时间为5.1个月,每人等待手术的平均总成本为4305新西兰元(2876美元)(1新西兰元 = 0.668美元)。等待超过6个月的总平均成本(4278新西兰元/2858美元/人)高于等待少于6个月的情况(2828新西兰元/1889美元/人;P <.01)。术前到术后WOMAC和EQ-5D评分有改善(P ≤.01)。等待时间越长,术前身体功能越差(P ≤.01)。初始健康状况较差的患者在术后6个月时WOMAC(P =.0001)和EQ-5D(P =.003)指标改善更大。等待全髋关节置换术的时间越长,等待期间产生的经济成本越高,身体功能恶化越严重。