Socioeconomic burden of total joint arthroplasty for symptomatic hip and knee osteoarthritis in the Italian population: A 5‐year analysis based on hospitalization records

Piscitelli, Prisco; Iolascon, Giovanni; Tanna, Gian Luca Di; Bizzi, Emanuele; Chitano, Giovanna; Argentiero, Alberto; Neglia, Cosimo; Giolli, Lorenzo; Distante, Alessandro; Gimigliano, Raffaele; Brandi, M. L.; Migliore, Alberto

doi:10.1002/acr.21706

Cited by 56 publications

(52 citation statements)

References 43 publications

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“…For adults it is one of the leading causes of disability (Chu et al, 2014;Ma et al, 2014) with a prevalence of 10.9% (Pereira et al, 2011). Additionally, osteoarthritis is a socioeconomic burden because of lost workdays (Kotlarz et al, 2010;Piscitelli et al, 2012;Rabenberg, 2013). Several factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

Varady

Glitsch

Augat

2015

Journal of Biomechanics

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Section: Introductionmentioning

confidence: 99%

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

Varady

Glitsch

Augat

2015

Journal of Biomechanics

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“…Per quanto riguarda il solo intervento di artroprotesi al ginocchio (total knee replacement, TKR) gli interventi nel 2013 sono stati circa 65.000, con una crescita media annua del 7,2% negli ultimi 10 anni (nel 2003 erano circa 37.000) (Progetto Registro Italiano Artroprotesi, RIAP) (16). Nel 2005, quando il numero di tali interventi era di circa 40.000 casi, il costo medio per paziente, comprensivo dei costi diretti e perdita di produttività, è stato calcolato in €15.000 (15). Considerando solo i costi diretti dell'intervento, il costo totale stimato è di circa 1 miliardo di euro (15,17).…”

Section: L'oa In Italiaunclassified

“…Nel 2005, quando il numero di tali interventi era di circa 40.000 casi, il costo medio per paziente, comprensivo dei costi diretti e perdita di produttività, è stato calcolato in €15.000 (15). Considerando solo i costi diretti dell'intervento, il costo totale stimato è di circa 1 miliardo di euro (15,17). Questo costo è in continua crescita seguendo il costante incremento degli interventi di artroprotesi.…”

Section: L'oa In Italiaunclassified

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Landi

Landa

Russo

2016

Global & Regional Health Technology Assessment

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ORIGINAL RESEARCH ARTICLErischio, tra i quali il genere (le donne sono più predisposte), l'età, il tipo di attività lavorativa, l'obesità (1-3).Le patologie muscoloscheletriche sono l'ottava causa a livello mondiale, e la quarta nei Paesi occidentali, per anni di vita persi per disabilità (disability-adjusted life-year, DALY). Almeno la metà delle patologie muscoloscheletriche sono attribuibili all'osteoartrosi (4) ed essa risulta essere l'undicesima patologia per peso di contribuzione alla disabilità a livello mondiale su 291 patologie, e trentottesima per DALY (5).Il carico medico e sociale dell'OA determina un forte impatto economico sui sistemi sanitari (6, 7), in particolare nei Paesi occidentali dove l'incidenza è più elevata. I costi sanitari diretti sono dovuti ai farmaci utilizzati per ridurre il dolore e la limitazione funzionale, esami medici, ricoveri e interventi chirurgici di sostituzione dell'articolazione danneggiata (artroprotesi). The increasing incidence of total joint arthroplasty reflects the rises of osteoarthritis (OA) prevalence. OA is a degenerative pathology affecting joints with a significant impact on quality of life causing pain, leading to social life limitations and loss of work productivity. According to the World Health Organization, OA is one of the most important causes of people's disability. The burden of the disease is correlated with a huge economic impact on the health care systems. Intra-articular infiltration therapies are used between the pharmacological and the surgical phases, in order to delay surgery. This work aims to carry out an economic evaluation on the use of the Platelet-RichPlasma (PRP) therapy in the treatment of knee OA. The comparator is the hyaluronic acid, i.e. the standard therapy for drug-resistant OA that does not benefit or has short term benefits (<1 month) with intra-articular corticosteroids. Methods: A cost-effectiveness analysis has been performed using a decision-analytic model considering two scenarios: short period and medium period. The effectiveness outcomes are reported in term of quality-adjusted life-years (QALYs), while costs are expressed in euro (€). The adopted perspective is the Italian National Health System (INHS). The results are shown through the incremental cost-effectiveness ratio (ICER) examining the PRP versus the comparator. Moreover, deterministic and probabilistic sensitivity analyses have been performed to test the robustness of the results. Results: The PRP therapy, for patients with moderate to severe knee OA in the Italian context, is cost-effective versus HA with ICERs of €1,524/QALY in the 1 year and €162/QALY in the 5 year scenarios. Conclusions: In the short term, it seems that the PRP therapy is cost-effective in the treatment of knee OA versus the HA therapy. However, more research is needed to assess its cost-effectiveness in the long term and to figure out if this treatment may be an efficient resource allocation for the INHS.

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“…The socioeconomic burden of care for TKR rehabilitation is an emerging issue also in Italy and requires the adoption of proper measure [10].…”

Section: Introductionmentioning

confidence: 99%

Setting, Clinical Pathways, Fast-Track and Rehabilitation Following Primary Knee Arthroplasty: A Literature Review

Benedetti¹,

Sarti²,

Stagni³

et al. 2015

TOREHJ

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In view of the high incidence of total knee replacements, it is important to identify the most efficient yet costeffective rehabilitation program, in order to optimize patient care within the constraints of the National Healthcare System. This paper aimed at reviewing the literature on post-acute Total Knee Replacement (TKR) rehabilitation discharge setting, and on the strategies for early discharge of TKR patients from orthopedic wards.Research studies on the effectiveness of rehabilitation in intensive rehabilitation care, skilled nursing facilities, home rehabilitation, fast-tracks, enhanced recovery and clinical pathways in total knee replacement patients have been reviewed.Length of stay following knee arthroplasty is influenced by the following factors: age, sex, marital status, co-morbidity, preoperative use of walking aids, pre and postoperative hemoglobin levels, the need for blood transfusion, ASA (American Society of Anesthesiologists) score and time between surgery and mobilization.Clinical pathways and fast tracks seem to be effective in reducing length of stay without increasing clinical complications. However, despite the vast quantity of literature available, results remain inconclusive. There is no clear evidence supporting an algorithm for the optimal rehabilitation management after total knee replacement.Beside the question of which setting or path is preferable in terms of organization, the review enlightens that it is relevant also gaining a deeper understanding of the most important predictors of the best outcomes.There is a need to review criteria for admitting total knee arthroplasty patients to intensive rehabilitation, to start a "fasttrack" protocol, to build "Clinical Pathways" and to discharge patients to home rehabilitation.

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Socioeconomic burden of total joint arthroplasty for symptomatic hip and knee osteoarthritis in the Italian population: A 5‐year analysis based on hospitalization records

Abstract: Objective. To assess the burden of total joint arthroplasties (TJAs) performed for symptomatic hip and knee osteoarthritis (OA) in the Italian population. Methods. We analyzed national hospitalizations and diagnosis-related group databases to compute incidence, annual percent change (

Cited by 56 publications

References 43 publications

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Setting, Clinical Pathways, Fast-Track and Rehabilitation Following Primary Knee Arthroplasty: A Literature Review

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