Skip to main content
Top
Gepubliceerd in: Quality of Life Research 2/2015

01-02-2015

Comparison of pre- and post-operative health-related quality of life and length of stay after primary total hip replacement in matched English and German patient cohorts

Auteurs: Matthias Vogl, Reiner Leidl, Werner Plötz, Nils Gutacker

Gepubliceerd in: Quality of Life Research | Uitgave 2/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

We compare pre- and post-operative health-related quality of life (HRQoL) and length of stay after total hip replacement (THR) in matched German and English patient cohorts to test for differences in admission thresholds, clinical effectiveness and resource utilisation between the healthcare systems.

Methods

German data (n = 271) were collected in a large orthopaedic hospital in Munich, Germany; English data (n = 26,254) were collected as part of the national patient-reported outcome measures programme. HRQoL was measured using the EuroQoL-5D instrument. Propensity score matching was used to construct two patient cohorts that are comparable in terms of preoperative patient characteristics.

Results

Before matching, patients in England showed lower preoperative EQ-5D scores (0.35 vs 0.52, p < 0.001) and experienced a larger improvement in HRQoL (0.43 vs 0.33, p < 0.001) than German patients. Patients in the German cohort were more likely to report no or only moderate problems with mobility and pain preoperatively than their English counterparts. After matching, improvements in HRQoL were comparable (0.32 vs 0.33, p = 0.638); post-operative scores were slightly higher in the German cohort (0.82 vs 0.85, p = 0.585). Length of stay was substantially lower in England than in Germany (4.5 vs 9.0 days, p < 0.001).

Conclusions

Our results highlight differences in preoperative health status between countries, which may arise due to different admission thresholds and access to surgery. In terms of quality of life, THR surgery is equally effective in both countries when performed on similar patients, but hospital stay is shorter in England.
Literatuur
1.
go back to reference Jenkins, P. J., Clement, N. D., Hamilton, D. F., Gaston, P., Patton, J. T., & Howie, C. R. (2013). Predicting the cost-effectiveness of total hip and knee replacement: a health economic analysis. Bone and Joint Journal, 95-B(1), 115–121.PubMedCrossRef Jenkins, P. J., Clement, N. D., Hamilton, D. F., Gaston, P., Patton, J. T., & Howie, C. R. (2013). Predicting the cost-effectiveness of total hip and knee replacement: a health economic analysis. Bone and Joint Journal, 95-B(1), 115–121.PubMedCrossRef
2.
go back to reference Imamura, K., & Black, N. (1998). Outcome of total hip replacement in Japan and England. Comparison of two retrospective cohorts. International Journal of Technology Assessment in Health Care, 14(4), 762–773.PubMedCrossRef Imamura, K., & Black, N. (1998). Outcome of total hip replacement in Japan and England. Comparison of two retrospective cohorts. International Journal of Technology Assessment in Health Care, 14(4), 762–773.PubMedCrossRef
3.
go back to reference Gordon, M., Paulsen, A., Overgaard, S., Garellick, G., Pedersen, A. B., & Rolfson, O. (2013). Factors influencing health-related quality of life after total hip replacement—a comparison of data from the Swedish and Danish hip arthroplasty registers. BMC Musculoskeletal Disorders, 14, 316.PubMedCentralPubMedCrossRef Gordon, M., Paulsen, A., Overgaard, S., Garellick, G., Pedersen, A. B., & Rolfson, O. (2013). Factors influencing health-related quality of life after total hip replacement—a comparison of data from the Swedish and Danish hip arthroplasty registers. BMC Musculoskeletal Disorders, 14, 316.PubMedCentralPubMedCrossRef
5.
go back to reference Klauber, J., Geraedts, M., Friedrich, J., & Wasem, J. (2013). Krankenhaus-Report 2013 Mengendynamik: Mehr Menge, mehr Nutzen? Stuttgart: Schattauer. Klauber, J., Geraedts, M., Friedrich, J., & Wasem, J. (2013). Krankenhaus-Report 2013 Mengendynamik: Mehr Menge, mehr Nutzen? Stuttgart: Schattauer.
7.
go back to reference Garbuz, D. S., Xu, M., Duncan, C. P., Masri, B. A., & Sobolev, B. (2006). Delays worsen quality of life outcome of primary total hip arthroplasty. Clinical Orthopaedics and Related Research, 447, 79–84.PubMedCrossRef Garbuz, D. S., Xu, M., Duncan, C. P., Masri, B. A., & Sobolev, B. (2006). Delays worsen quality of life outcome of primary total hip arthroplasty. Clinical Orthopaedics and Related Research, 447, 79–84.PubMedCrossRef
8.
go back to reference Vergara, I., Bilbao, A., Gonzalez, N., Escobar, A., & Quintana, J. (2011). Factors and consequences of waiting times for total hip arthroplasty. Clinical Orthopaedics and Related Research®, 469(5), 1413–1420.CrossRef Vergara, I., Bilbao, A., Gonzalez, N., Escobar, A., & Quintana, J. (2011). Factors and consequences of waiting times for total hip arthroplasty. Clinical Orthopaedics and Related Research®, 469(5), 1413–1420.CrossRef
9.
go back to reference Hoogeboom, T. J., van den Ende, C. H. M., van der Sluis, G., Elings, J., Dronkers, J. J., Aiken, A. B., et al. (2009). The impact of waiting for total joint replacement on pain and functional status: A systematic review. Osteoarthritis and Cartilage, 17(11), 1420–1427.PubMedCrossRef Hoogeboom, T. J., van den Ende, C. H. M., van der Sluis, G., Elings, J., Dronkers, J. J., Aiken, A. B., et al. (2009). The impact of waiting for total joint replacement on pain and functional status: A systematic review. Osteoarthritis and Cartilage, 17(11), 1420–1427.PubMedCrossRef
10.
go back to reference Street, A., Gutacker, N., Bojke, C., Devlin, N., & Daidone, S. (2014). Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Serv Deliv Res, 2(1). Street, A., Gutacker, N., Bojke, C., Devlin, N., & Daidone, S. (2014). Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Serv Deliv Res, 2(1).
11.
go back to reference Dall, G. F., Ohly, N. E., Ballantyne, J. A., & Brenkel, I. J. (2009). The influence of pre-operative factors on the length of in-patient stay following primary total hip replacement for osteoarthritis: A multivariate analysis of 2302 patients. Journal of Bone and Joint Surgery British, 91(4), 434–440.CrossRef Dall, G. F., Ohly, N. E., Ballantyne, J. A., & Brenkel, I. J. (2009). The influence of pre-operative factors on the length of in-patient stay following primary total hip replacement for osteoarthritis: A multivariate analysis of 2302 patients. Journal of Bone and Joint Surgery British, 91(4), 434–440.CrossRef
13.
go back to reference Dolan, P. (1996). Modelling valuations for health states: The effect of duration. Health Policy, 38(3), 189–203.PubMedCrossRef Dolan, P. (1996). Modelling valuations for health states: The effect of duration. Health Policy, 38(3), 189–203.PubMedCrossRef
14.
go back to reference Kind, P., Brooks, R., & Rabin, R. (2005). EQ-5D concepts and methods: A developmental history. Dordrecht: Springer.CrossRef Kind, P., Brooks, R., & Rabin, R. (2005). EQ-5D concepts and methods: A developmental history. Dordrecht: Springer.CrossRef
15.
go back to reference Austin, P. C. (2009). Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Statistics in Medicine, 28(25), 3083–3107.PubMedCentralPubMedCrossRef Austin, P. C. (2009). Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Statistics in Medicine, 28(25), 3083–3107.PubMedCentralPubMedCrossRef
16.
go back to reference Ethgen, O., Bruyere, O., Richy, F., Dardennes, C., & Reginster, J. Y. (2004). Health-related quality of life in total hip and total knee arthroplasty: A qualitative and systematic review of the literature. The Journal of Bone and Joint Surgery, 86-A(5), 963–974.PubMed Ethgen, O., Bruyere, O., Richy, F., Dardennes, C., & Reginster, J. Y. (2004). Health-related quality of life in total hip and total knee arthroplasty: A qualitative and systematic review of the literature. The Journal of Bone and Joint Surgery, 86-A(5), 963–974.PubMed
17.
go back to reference Biring, G. S., Masri, B. A., Greidanus, N. V., Duncan, C. P., & Garbuz, D. S. (2007). Predictors of quality of life outcomes after revision total hip replacement. Journal of Bone and Joint Surgery British, 89(11), 1446–1451.CrossRef Biring, G. S., Masri, B. A., Greidanus, N. V., Duncan, C. P., & Garbuz, D. S. (2007). Predictors of quality of life outcomes after revision total hip replacement. Journal of Bone and Joint Surgery British, 89(11), 1446–1451.CrossRef
18.
go back to reference Husted, H., Holm, G., & Jacobsen, S. (2008). Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: Fast-track experience in 712 patients. Acta Orthopaedica, 79(2), 168–173.PubMedCrossRef Husted, H., Holm, G., & Jacobsen, S. (2008). Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: Fast-track experience in 712 patients. Acta Orthopaedica, 79(2), 168–173.PubMedCrossRef
19.
go back to reference Bjorgul, K., Novicoff, W., & Saleh, K. (2010). Evaluating comorbidities in total hip and knee arthroplasty: available instruments. Journal of Orthopaedics and Traumatology, 11(4), 203–209.PubMedCentralPubMedCrossRef Bjorgul, K., Novicoff, W., & Saleh, K. (2010). Evaluating comorbidities in total hip and knee arthroplasty: available instruments. Journal of Orthopaedics and Traumatology, 11(4), 203–209.PubMedCentralPubMedCrossRef
20.
go back to reference Rassen, J. A., Shelat, A. A., Myers, J., Glynn, R. J., Rothman, K. J., & Schneeweiss, S. (2012). One-to-many propensity score matching in cohort studies. Pharmacoepidemiology and Drug Safety, 21(Suppl 2), 69–80.PubMedCrossRef Rassen, J. A., Shelat, A. A., Myers, J., Glynn, R. J., Rothman, K. J., & Schneeweiss, S. (2012). One-to-many propensity score matching in cohort studies. Pharmacoepidemiology and Drug Safety, 21(Suppl 2), 69–80.PubMedCrossRef
21.
go back to reference Austin, P. C. (2011). Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharmaceutical Statistics, 10(2), 150–161.PubMedCentralPubMedCrossRef Austin, P. C. (2011). Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharmaceutical Statistics, 10(2), 150–161.PubMedCentralPubMedCrossRef
22.
go back to reference Austin, P. C. (2009). Some methods of propensity-score matching had superior performance to others: Results of an empirical investigation and Monte Carlo simulations. Biometrical Journal, 51(1), 171–184.PubMedCrossRef Austin, P. C. (2009). Some methods of propensity-score matching had superior performance to others: Results of an empirical investigation and Monte Carlo simulations. Biometrical Journal, 51(1), 171–184.PubMedCrossRef
23.
go back to reference Pearse, R. M., Moreno, R. P., Bauer, P., Pelosi, P., Metnitz, P., Spies, C., et al. (2012). Mortality after surgery in Europe: A 7 day cohort study. Lancet, 380(9847), 1059–1065.PubMedCentralPubMedCrossRef Pearse, R. M., Moreno, R. P., Bauer, P., Pelosi, P., Metnitz, P., Spies, C., et al. (2012). Mortality after surgery in Europe: A 7 day cohort study. Lancet, 380(9847), 1059–1065.PubMedCentralPubMedCrossRef
24.
go back to reference Stargardt, T. (2008). Health service costs in Europe: Cost and reimbursement of primary hip replacement in nine countries. Health Economics, 17(1 Suppl), S9–20.PubMedCrossRef Stargardt, T. (2008). Health service costs in Europe: Cost and reimbursement of primary hip replacement in nine countries. Health Economics, 17(1 Suppl), S9–20.PubMedCrossRef
25.
go back to reference Coleman, M. P., Quaresma, M., Berrino, F., Lutz, J. M., De Angelis, R., Capocaccia, R., et al. (2008). Cancer survival in five continents: A worldwide population-based study (CONCORD). The Lancet Oncology, 9(8), 730–756.PubMedCrossRef Coleman, M. P., Quaresma, M., Berrino, F., Lutz, J. M., De Angelis, R., Capocaccia, R., et al. (2008). Cancer survival in five continents: A worldwide population-based study (CONCORD). The Lancet Oncology, 9(8), 730–756.PubMedCrossRef
27.
go back to reference Gutacker, N., Bojke, C., Daidone, S., Devlin, N. J., Parkin, D., & Street, A. (2013). Truly inefficient or providing better quality of care? Analysing the relationship between risk-adjusted hospital costs and patients’ health outcomes. Health Economics, 22(8), 931–947.PubMedCrossRef Gutacker, N., Bojke, C., Daidone, S., Devlin, N. J., Parkin, D., & Street, A. (2013). Truly inefficient or providing better quality of care? Analysing the relationship between risk-adjusted hospital costs and patients’ health outcomes. Health Economics, 22(8), 931–947.PubMedCrossRef
28.
go back to reference Laudicella, M., Siciliani, L., & Cookson, R. (2012). Waiting times and socioeconomic status: Evidence from England. Social Science and Medicine, 74(9), 1331–1341.PubMedCrossRef Laudicella, M., Siciliani, L., & Cookson, R. (2012). Waiting times and socioeconomic status: Evidence from England. Social Science and Medicine, 74(9), 1331–1341.PubMedCrossRef
29.
go back to reference Haanstra, T. M., van den Berg, T., Ostelo, R. W., Poolman, R. W., Jansma, E. P., Cuijpers, P., et al. (2012). Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty? Health Quality Life Outcomes, 10, 152.CrossRef Haanstra, T. M., van den Berg, T., Ostelo, R. W., Poolman, R. W., Jansma, E. P., Cuijpers, P., et al. (2012). Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty? Health Quality Life Outcomes, 10, 152.CrossRef
30.
go back to reference Rice, N., Robone, S., & Smith, P. C. (2012). Vignettes and health systems responsiveness in cross-country comparative analyses. Journal of the Royal Statistical Society: Series A (Statistics in Society), 175(2), 337–369.CrossRef Rice, N., Robone, S., & Smith, P. C. (2012). Vignettes and health systems responsiveness in cross-country comparative analyses. Journal of the Royal Statistical Society: Series A (Statistics in Society), 175(2), 337–369.CrossRef
31.
go back to reference Murray, C. J. L., Özaltin, E., Tandon, A., Salomon, J. A., Sadana, R., & Chatterji, S. (2003). Empirical evaluation of the anchoring vignette approach in health surveys (Chapter 30). In C. J. L. Murray & D. B. Evans (Eds.), Health systems performance assessment: Debates, methods and empiricism. Geneva: Word Health Organisation. Murray, C. J. L., Özaltin, E., Tandon, A., Salomon, J. A., Sadana, R., & Chatterji, S. (2003). Empirical evaluation of the anchoring vignette approach in health surveys (Chapter 30). In C. J. L. Murray & D. B. Evans (Eds.), Health systems performance assessment: Debates, methods and empiricism. Geneva: Word Health Organisation.
32.
go back to reference Bago d’Uva, T., Van Doorslaer, E., Lindeboom, M., & O’Donnell, O. (2008). Does reporting heterogeneity bias the measurement of health disparities? Health Economics, 17(3), 351–375.PubMedCrossRef Bago d’Uva, T., Van Doorslaer, E., Lindeboom, M., & O’Donnell, O. (2008). Does reporting heterogeneity bias the measurement of health disparities? Health Economics, 17(3), 351–375.PubMedCrossRef
33.
go back to reference Salomon, J. A., Tandon, A., & Murray, C. J. (2004). Comparability of self rated health: Cross sectional multi-country survey using anchoring vignettes. BMJ, 328(7434), 258.PubMedCentralPubMedCrossRef Salomon, J. A., Tandon, A., & Murray, C. J. (2004). Comparability of self rated health: Cross sectional multi-country survey using anchoring vignettes. BMJ, 328(7434), 258.PubMedCentralPubMedCrossRef
34.
go back to reference Jurges, H. (2007). True health vs response styles: Exploring cross-country differences in self-reported health. Health Economics, 16(2), 163–178.PubMedCrossRef Jurges, H. (2007). True health vs response styles: Exploring cross-country differences in self-reported health. Health Economics, 16(2), 163–178.PubMedCrossRef
35.
go back to reference Knies, S., Evers, S. M., Candel, M. J., Severens, J. L., & Ament, A. J. (2009). Utilities of the EQ-5D: transferable or not? Pharmacoeconomics, 27(9), 767–779.PubMedCrossRef Knies, S., Evers, S. M., Candel, M. J., Severens, J. L., & Ament, A. J. (2009). Utilities of the EQ-5D: transferable or not? Pharmacoeconomics, 27(9), 767–779.PubMedCrossRef
36.
go back to reference Leidl, R., & Reitmeir, P. (2011). A value set for the EQ-5D based on experienced health states: Development and testing for the German population. Pharmacoeconomics, 29(6), 521–534.PubMedCrossRef Leidl, R., & Reitmeir, P. (2011). A value set for the EQ-5D based on experienced health states: Development and testing for the German population. Pharmacoeconomics, 29(6), 521–534.PubMedCrossRef
37.
38.
go back to reference Pinedo-Villanueva, R. A., Turner, D., Judge, A., Raftery, J. P., & Arden, N. K. (2013). Mapping the Oxford hip score onto the EQ-5D utility index. Quality of Life Research, 22(3), 665–675.PubMedCrossRef Pinedo-Villanueva, R. A., Turner, D., Judge, A., Raftery, J. P., & Arden, N. K. (2013). Mapping the Oxford hip score onto the EQ-5D utility index. Quality of Life Research, 22(3), 665–675.PubMedCrossRef
Metagegevens
Titel
Comparison of pre- and post-operative health-related quality of life and length of stay after primary total hip replacement in matched English and German patient cohorts
Auteurs
Matthias Vogl
Reiner Leidl
Werner Plötz
Nils Gutacker
Publicatiedatum
01-02-2015
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 2/2015
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-014-0782-9

Andere artikelen Uitgave 2/2015

Quality of Life Research 2/2015 Naar de uitgave