全髋关节置换术后工作年龄患者康复治疗的效果：荷兰与德国常规治疗的比较。

Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany.

机构信息

Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany.

出版信息

BMC Musculoskelet Disord. 2023 Jun 27;24(1):525. doi: 10.1186/s12891-023-06654-w.

DOI:10.1186/s12891-023-06654-w

PMID:37370054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10294515/

Abstract

BACKGROUND

Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.

METHODS

A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.

RESULTS

124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.

CONCLUSIONS

German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.

TRIAL REGISTRATION

The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).

摘要

背景

初次全髋关节置换术（p-THA）后的术后康复在荷兰和德国有所不同。目的是比较临床效果，并初步了解荷兰与德国 p-THA 后常规护理的成本效益。

方法

一项跨国前瞻性对照观察性试验。通过自我报告问卷和功能测试评估临床效果。在术前、术后 4 周、12 周和 6 个月进行测量。为了评估成本效益，从社会角度评估了长期的经济方面。

结果

124 名处于工作年龄的患者完成了测量。德国常规护理在术后 12 周时使更大部分（65.6%对 47.5%）的患者感到满意，并且自我报告的功能和 5 次坐立试验（FTSST）结果明显更好。德国常规护理通常比荷兰常规护理贵 45%，对工作年龄的患者贵 20%。一个情景分析假设德国患者的工作时间与荷兰患者相同，并且生产力成本相同。该分析显示德国护理仍然更昂贵，但差异缩小到 8%。