Is Longer Waiting Time for Total Knee Replacement Associated with Health Outcomes and Medication Costs? Randomized Clinical Trial

Abstract

Those in the SWT group had higher weekly costs of medication at admission, and reached better HRQoL 3 months earlier than those in the NFWT group, but the latter had better HRQoL after operation. Otherwise, the length of WT was not associated with different health and HRQoL outcomes in the groups.

The Impact of Waiting Time on Health Gains from Surgery: Evidence from a National Patient‐reported Outcome Dataset

“…The existing evidence of the impact of waiting time on health outcomes for less urgent treatment is less conclusive. Randomised controlled trials of alternative scheduling of rheumatology appointments (Hurst, et al , ) or joint replacement (Tuominen, et al , ; Hirvonen, et al , ) show that longer waiting time for treatment is not associated with poorer health status at admission nor poorer post‐treatment outcomes. Findings from studies using observational data are more equivocal.…”

“…The randomised controlled trials have focused on comparing routine waiting times with faster access to treatment. In these studies, fast access ranged from 1 to 3 months (Hurst, et al , ; Tuominen, et al , ) whilst routine waiting times ranged from 3 to 8 months (Hurst, et al , ; Tuominen, et al , ). In contrast, the observational studies that find significant, negative impacts of waiting time on outcomes arise from long waits, typically of 6–12 months or longer (Noseworthy, et al , ; Hajat, et al , ; Sarin, et al , ).…”

“…One further potential explanation is the outcome measures used to estimate the impact on health. The randomised controlled trials used generic health-related quality-of-life measures (Tuominen, et al, 2010;Hurst, et al, 2000;Hirvonen, et al, 2007) whereas observational studies have used more disease-specific measures of function (Noseworthy, et al, 2005;Hajat, et al, 2002), which may be more sensitive to specific symptoms.…”

Health Economic Aspects

“…The authors discuss that the latter result could be due to the fact that patients within the shorter waiting period group had more severe pain at the time of inclusion in the study. No statistically significant differences with regard to the weekly cost of medication could be found at the time of the three month follow-up and one year after surgery (Tuominen et al 2010).…”

“…A randomized controlled study conducted in Finland of patients who underwent TKA to determine whether delayed or untimely treatment leads to (additional) costs presents the following results (Tuominen et al 2010). Over 400 osteoarthritis patients were randomly allocated either to a waiting list for surgery to take place within three months or, as is common in normal hospital routine, to a waiting list with a waiting period of longer than three months.…”