What is the current evidence for cost of waiting on the outpatient list for management/treatment of orthopaedic/musculoskeletal complaints? A systematic review

Abstract

Little is known about costs of waiting for orthopaedic outpatient specialist consultations. A subset of papers on costs of waiting was identified from the body of literature identified in a systematic scoping review registered with Prospero (registration CRD42016047332), with the aim of exploring the impact of waiting for orthopaedic outpatient specialist consultations. Medline, Embase, Pubmed, and NHS Economic evaluation database (NHS-EED) were searched from inception until February 2018. The systematic scoping search yielded 139 articles, of which four reported specifically on costs (papers published 2002, 2005, 2009, 2012). All papers reported on hip and/or knee complaints. Cost data was extracted, described and standardised as Australian dollars (AUD$). This review identified limited, non-current evidence on economic costs of waiting for outpatient orthopaedic surgical consultations. Whilst heterogeneous cost items, timing of collection, and dispersion measures constrained synthesis, it appears that direct and indirect costs of waiting may be significant to patients and health systems. Pharmaceuticals were the most common cost (from $263-$1,912). Future research into costs of waiting for orthopaedic conditions should report standardised cost measures, taken at standard time periods throughout the waiting period.