Suarez-Almazor ME, Jones CA, Kaul P, Voaklander D, Johnston DW; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1999; 15: 57.
Department of Public Health Sciences, University of Alberta, Edmonton, AB T6G 2S2, Canada.
OBJECTIVE: To estimate the quality-adjusted life expectancy of a population-based cohort of patients undergoing total hip (THA) or total knee (TKA) arthroplasty. METHODS: The population for this study included all patients residing in our health district who were placed in a waiting list for THA or TKA between January 1996 and January 1997. Study participants were interviewed prior to and 6 months after their surgery. The EuroQol questionnaire was used to obtain health-related quality of life scores. The EuroQol was rated using time trade-off utility scores obtained from the general population. QALYs were calculated using the EuroQol and specific age-sex life expectancies for the general population, under the assumption derived from the available literature that patients undergoing THA or TKA have mortality rates similar to those in the general population. The baseline EuroQol was used to estimate remaining QALYs assuming no intervention. The 6-month EuroQol was used to estimate QALYs after receiving an arthroplasty. Differences in QALYs between the 2 scenarios were calculated without discounting, and with a 3% annual discount in quality of life. RESULTS: Five hundred and six patients participated in the study of whom 486 had complete EuroQol scores at baseline and 6 months; 60% were female, 67% were 65 or older; 92% had osteoarthritis. Two hundred and twenty one (45%) had THA and 265 (55%) TKA. For THA the mean gain in QALYs after surgery without discounting was estimated to be 6.0, and with 3% discounting 4.4. For TKA these values were estimated to be 4.0 and 3.0 respectively. We conducted a multivariate analysis to evaluate which patients would benefit the most in QALY gains. Results were similar for THA and TKA with lower age and lower baseline health status (EuroQol) being significantly related to greater gains. Direct costs of THA and TKA range between $10,000 and $25,000 in different countries and health systems. This places the cost-utility of a THA within a range of $1,667 to $5,682 per gained QALY, and for TKA within a range of $2,500 to $8,333 per QALY. CONCLUSIONS: THA and TKA result in significant gains in quality-adjusted life expectancy. and can be considered cost-effective when compared to other elective surgical procedures.
Publication Types:
Keywords:
- Animals
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Female
- Hip Prosthesis
- Humans
- Life Expectancy
- Osteoarthritis
- Quality-Adjusted Life Years
- Questionnaires
- surgery
- hsrmtgs
Other ID:
UI: 102193813
From Meeting Abstracts