Research Department, Kliniek ViaSana, Hoogveldseweg 1, 5451 AA, Mill, The Netherlands.
Department of Orthopaedic Surgery, Sports & Orthopaedics Research Centre, Sint Anna Ziekenhuis, Bogardeind 2, 5664 EH, Geldrop, The Netherlands.
Health Qual Life Outcomes. 2023 Mar 14;21(1):24. doi: 10.1186/s12955-023-02104-2.
Joint arthroplasty registries have incorporated patient-reported outcomes (PROs) to evaluate outcomes from a patients' perspective to improve total hip arthroplasty (THA). To draw valid conclusions on PROs, a minimum response rate (RR) of 60% is advised. This study investigated (1) if the quality of THA health care based on PROs improved over the years in the Netherlands, (2) if RRs improved over the years, and (3) difference in PROs over the years in hospitals with RR ≥ 60% compared to RR < 60%.
Longitudinal study with publicly available datasets from 2016 to 2019. Primary outcome was increase/decrease in PRO change scores including 95%CI ranges over the years between preoperatively and 3 months postoperatively (pre-3 m), and 12 months postoperatively (pre-12 m). Improved quality of health care was arbitrary defined as when ≥ 3 of 4 included scores or ranges were statistically significant improved. Secondary outcome was increase/decrease in RRs over the years. Subgroups RR ≥ 60% and RR < 60% were compared.
Hospitals (%) collecting THA PROs increased from 78 to 92%. EQ VAS change score increased over the years, and 95%CI ranges of EQ VAS, EQ-5D descriptive system and NRS pain during activity decreased over the years at pre-3 m (p < 0.05). All THA pre-12 m PRO change scores and 95%CI ranges remained equal (p > 0.05). Pre-3 m RR remained equal (around 43%, p = 0.107) and pre-12 m RR decreased 9% (49% to 40%, p = 0.008). Pre-3 m subgroup RR ≥ 60% was too small to analyse (5%). No difference was found between pre-12 m subgroups (RR ≥ 60% = 16%), p > 0.05).
Quality of THA health care based on PROs seems equal in the Netherlands between 2016 and 2019. Although more hospitals participated in PRO collection, low RRs with large IQRs are observed and only 16% of the hospitals achieved the advised RR ≥ 60%. Multiple recommendations are provided to improve PRO collection and use.
关节置换登记处已经纳入了患者报告的结果（PROs），从患者的角度评估髋关节置换术（THA）的结果，以改善治疗效果。为了得出有效的 PRO 结论，建议最低应答率（RR）为 60%。本研究调查了：（1）基于 PRO 的荷兰 THA 医疗保健质量是否逐年提高；（2）RR 是否逐年提高；（3）RR≥60%的医院与 RR<60%的医院相比，PRO 多年来的差异。
使用 2016 年至 2019 年的公开数据集进行纵向研究。主要结局是术前和术后 3 个月（pre-3m）以及术后 12 个月（pre-12m）PRO 变化评分的增加/减少，包括 95%CI 范围。任意定义的医疗保健质量改善是指 4 项纳入评分或范围中≥3 项有统计学意义的改善。次要结局是 RR 逐年增加。比较 RR≥60%和 RR<60%的亚组。
收集 THA PRO 的医院比例从 78%增加到 92%。EQ VAS 变化评分逐年增加，EQ VAS、EQ-5D 描述系统和活动时 NRS 疼痛的 95%CI 范围在 pre-3m 时逐年降低（p<0.05）。所有 THA pre-12m PRO 变化评分和 95%CI 范围均保持不变（p>0.05）。pre-3m RR 保持不变（约 43%，p=0.107），pre-12m RR 降低了 9%（49%至 40%，p=0.008）。pre-3m 亚组 RR≥60%的比例太小，无法进行分析（5%）。pre-12m 亚组之间未发现差异（RR≥60%=16%，p>0.05）。
2016 年至 2019 年间，荷兰基于 PRO 的 THA 医疗保健质量似乎相同。尽管有更多的医院参与了 PRO 的收集，但观察到的 RR 较低且 IQR 较大，只有 16%的医院达到了建议的 RR≥60%。为了改善 PRO 的收集和使用，提供了多项建议。
