A Population-Based Nested Case-Control Study of the Costs of Hip and Knee Replacement Surgery
Bibliographic Data
| ID | 9100322 |
|---|---|
| Authors | Gillian Hawker (0000-0001-6358-1197, University of Toronto, corresponding author), Gillian A Hawker, E M Badley (0000-0002-6045-2549, University of Toronto), Ruth Croxford (0000-0002-6738-0402, Hospital for Sick Children), Peter C Coyte (0000-0002-2993-3491, University of Toronto), Richard H Glazier (0000-0002-7952-8320, St. Michael's Hospital, corresponding author), Jun Guan (0000-0002-0747-9515, Institute for Clinical Evaluative Sciences), Bart J Harvey (University of Toronto), J I Williams (0000-0002-9855-8410), James G Wright (0000-0002-7790-4660, Hospital for Sick Children) |
| Year | 2009 |
| Volume | 47 |
| Issue | 7 |
| Pages | 732-741 |
| Publication date | 2009-07-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3181934553 |
| PMID | 19536034 |
| OpenAlex | W2067238281 |
| Language | EN |
| References cited | 23 |
BACKGROUND: Studies of total joint arthroplasty (TJA) have not evaluated the costs and outcomes in the context of expected arthritis worsening. OBJECTIVES: Using a cost-consequence approach, to examine changes in direct health care costs and arthritis severity after TJA for hip/knee arthritis compared with contemporaneous changes in matched controls. RESEARCH DESIGN: Case control study nested in a population-based prospective cohort. SUBJECTS: In a population cohort with disabling hip/knee osteoarthritis followed from 1996 to 2003, primary TJA recipients were matched with cohort nonrecipients on age, sex, region of residence, comorbidity, and inflammatory arthritis diagnosis. MEASURES: Pre- and postoperative total and arthritis-attributable direct health care costs, arthritis severity, and general health status were compared for cases and matched controls. RESULTS: Of 2109 participants with no prebaseline TJA, 185 cases received a single elective TJA during the follow-up period; of these, 183 cases and controls were successfully matched. Mean age was 71 years, 77.6% were female, 35.5% had > or =2 comorbidities, and 81.5% had > or =2 joints affected. At baseline, controls had less pain and disability and lower total and arthritis-attributable health care costs than cases. After surgery, although overall health care utilization was unchanged, cases experienced significant decreases in arthritis-attributable costs (mean decrease $278 including prescription drugs) and pain and disability (P < 0.0001 for all). Over the same time period, controls experienced a significant increase in total health care costs (mean increase $1978 including prescription drugs, P = 0.04) and no change or worsening of their arthritis status. CONCLUSION: Compared with matched controls, arthroplasty is associated with significant reductions in pain, disability, and arthritis-attributable direct costs
Arthritis · Arthroplasty · Cohort · Cohort study · Comorbidity · Context (archaeology) · Environmental health · Knee arthritis · Knee replacement · Nested case-control study · Osteoarthritis · Physical therapy · Population · Internal Medicine · Medicine · Orthopaedic implants and arthroplasty · Osteoarthritis Treatment and Mechanisms · Surgery · Total Knee Arthroplasty Outcomes
| Citation velocity | historical |
|---|---|
| Highly cited | No |