Mascarenhas Randy
Section of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada.
J Eval Clin Pract. 2009 Feb;15(1):208-11. doi: 10.1111/j.1365-2753.2008.00985.x.
With the aging population, arthritis of the hip and knee is increasing exponentially. While total joint replacement of the hip and knee have been proven to provide excellent outcomes for this debilitating clinical entity, the demand in Canada has grown to such an extent that there are thousands of people suffering on wait lists across the country. There have been numerous recent studies focusing on the effects that waiting have on patient post-operative subjective and objective clinical outcomes.
This commentary attempts to provide a review of the relevant data on the impact that waiting has on the health related quality of life of these patients. Additionally, the hip and knee arthroplasty wait list in Manitoba is illustrated to provide an example of interventions that have helped to combat a potential crisis situation in the province.
The literature on the impact of waiting times on health-related quality of life in hip and knee arthroplasty patients is reviewed. The example of the Manitoba arthroplasty waiting list is then provided to illustrate potential measures that can be implemented to decrease waiting times.
The literature shows that health-related quality of life declines as patients wait for surgery. The interventions that the province of Manitoba has implemented in the last seven years seem to be reducing waiting times and the number of patients on the waiting list.
The framework used in Manitoba may serve as an example for other provinces and potentially countries that find themselves faced with the same problem. However, more measures are required to build on the positive results encountered with these initial successes.
随着人口老龄化,髋膝关节关节炎的发病率呈指数级增长。虽然髋关节和膝关节置换术已被证明能为这种使人衰弱的临床病症带来良好疗效,但在加拿大,这一需求增长到了如此程度,以至于全国各地有成千上万的人在等待名单上受苦。最近有许多研究聚焦于等待对患者术后主观和客观临床结果的影响。
本评论旨在回顾关于等待对这些患者健康相关生活质量影响的相关数据。此外,还展示了曼尼托巴省的髋膝关节置换术等待名单,以举例说明有助于应对该省潜在危机情况的干预措施。
回顾了关于等待时间对髋膝关节置换术患者健康相关生活质量影响的文献。然后以曼尼托巴省置换术等待名单为例,说明可实施的减少等待时间的潜在措施。
文献表明,随着患者等待手术,其健康相关生活质量会下降。曼尼托巴省在过去七年中实施的干预措施似乎正在减少等待时间和等待名单上的患者数量。
曼尼托巴省使用的框架可为其他面临同样问题的省份甚至国家提供范例。然而,需要采取更多措施在这些初步成功所取得的积极成果基础上进一步发展。