The burden of waiting for hip and knee replacements in Ontario*

Journal of Evaluation in Clinical Practice - Tập 3 Số 1 - Trang 59-68 - 1997
Jack I. Williams1,2,3, Hilary A. Llewellyn‐Thomas1,4,3, Rena Arshinoff1, Nancy L. Young5, C. David Naylor1,6,3
1Clinical Epidemiology Unit, Sunnybrook Health Science Centre, North York, Ontario
2Faculty of Nursing, University of Toronto
3The Institute for Clinical Evaluative Sciences, North York, Ontario
4Institute of Medical Science, University of Toronto
5Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario
6Departments of Medicine and Surgery, University of Toronto

Tóm tắt

AbstractThe objectives of this study were to assess the impact of major joint replacements in reducing pain and disability and to describe the burden of pain and disability that could be avoided by ordering the queues with respect to severity of disease. A secondary goal was to compare the uses of a general health status measure, the Short Form Health Survey (SF‐36), and a disease‐specific measure, the Western Ontario McMaster Osteoarthritis Index (WOMAC), for accomplishing the objectives.The results are based on interviews with 209 patients before and after they had surgery. Only 15.9% of the patients had surgery within 3 months' waiting time, 19.2% waited 4–6 months, 30.7% waited 7–9 months, and the remaining 34.1 % waited a year or more. The waiting times were unrelated to the seventy of pain or disability reported in the initial interview.Following surgery, there were large reductions in the WOMAC scores for pain, stiffness and difficulty in functioning. The SF‐36 showed substantial improvements in relief from pain and in physical functioning, and reductions in role limitation due to physical problems, but not for scores related to mental health. The WOMAC scores were more responsive to the benefits of surgery than the SF‐36 scores.Queuing systems keyed on burden of symptoms could reduce the burden of pain and disability suffered by patients awaiting surgery. The improvements from hip and knee replacements suggest that equitable access for these procedures should be a priority in Ontario.

Từ khóa


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Journal of Evaluation in Clinical Practice

Tập 3 Số 1

59-68

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