Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial.

Autor: Kauppila AM; Oulu University Hospital, Finland. anna-maija.kauppila@oulu.fi, Sintonen H, Aronen P, Ohtonen P, Kyllönen E, Arokoski JP
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2011 Mar; Vol. 63 (3), pp. 335-41. Date of Electronic Publication: 2010 Nov 15.
DOI: 10.1002/acr.20398
Abstrakt: Objective: To conduct an economic evaluation of a multidisciplinary, biopsychosocial outpatient rehabilitation program implemented 2-4 months after total knee arthroplasty (TKA), compared with conventional orthopedic care.
Methods: After surgery, 86 patients were randomized to a multidisciplinary rehabilitation group (n = 44) or a conventional orthopedic care group (n = 42). Alongside the randomized controlled trial, we estimated the costs of rehabilitation, health care resource use, and community support. Information about resource use was collected by means of a questionnaire together with data from hospital records. The primary outcome (effectiveness) measure was change in self-reported functional capacity and the secondary measure was quality-adjusted life years (QALYs) gained during the 12-month followup. Cost-effectiveness was assessed from between-group differences in costs, change in functional capacity, and QALYs gained.
Results: Both protocols of providing rehabilitation services turned out to be equally effective, but the conventional orthopedic care protocol was unequivocally cost saving: the saving was €1,830 per patient (95% confidence interval -548, 3,623) using the available direct cost data.
Conclusion: Multidisciplinary rehabilitation for unselected osteoarthritis patients in the subacute period of recovery after TKA is not a cost-effective use of health care resources. Similar rehabilitation protocols cannot be recommended for clinical pathways of TKA in the future.
(Copyright © 2011 by the American College of Rheumatology.)
Databáze: MEDLINE
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