Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs

被引:310
作者
Rasanen, Pirjo
Paavolainen, Pekka
Sintonen, Hard
Koivisto, Anna-Maija
Marja, B.
Ryynanen, Olli-Pekka
Roine, Risto P.
机构
[1] Helsinki & Uusimaa Hosp Grp, Grp Adm, Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Dept Orthopaed, Helsinki, Finland
[3] Orton Orthopaed Hosp, Invalid Fdn, Helsinki, Finland
[4] Univ Helsinki, Dept Publ Hlth, Helsinki, Finland
[5] Finnish Off Hlth Technol Assessment, Helsinki, Finland
[6] Tampere Univ, Sch Publ Hlth, FIN-33101 Tampere, Finland
[7] Univ Helsinki, Cent Hosp, Jorvi Hosp, Espoo, Finland
[8] Acad Finland, Helsinki, Finland
[9] Univ Kuopio, Dept Hlth Policy & Management, FIN-70211 Kuopio, Finland
关键词
D O I
10.1080/17453670610013501
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background Concurrent head-to-head comparisons of healthcare interventions regarding cost-utility are rare. The concept of favorable cost-effectiveness of total hip or knee arthroplasty is thus inadequately verified. Patients and methods In a trial involving several thousand patients from 10 medical specialties, 223 patients who were enrolled for hip or knee replacement surgery were asked to fill in the 15D health-related quality of life (HRQoL) survey before and after operation. Results Mean (SD) HRQoL score (on a 0-1 scale) increased in primary hip replacement patients (n = 96) from 0.81 (0.084) preoperatively to 0.86 (0.12) at 12 months (p < 0.001). In revision hip replacement (n = 24) the corresponding scores were 0.81 (0.086) and 0.82 (0.097) respectively (p = 0.4), and in knee replacement (n = 103) the scores were 0.81 (0.093) and 0.84 (0.11) respectively (p < 0.001). Of 15 health dimensions, there were statistically significant improvements in moving, usual activities, discomfort and symptoms, distress, and vitality in both primary replacement groups. Mean cost per quality-adjusted life year (QALY) gained during a 1-year period was EURO 6,710 for primary hip replacement, EURO 52,274 for revision hip replacement, and EURO 13,995 for primary knee replacement. Interpretation Mp and knee replacement both improve HRQoL. The cost per QALY gained from knee replacement is twice that gained from hip replacement.
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页码:108 / 115
页数:8
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