| Autor: |
de Oliveira Silva, Danilo, Barton, Christian, Gibbs, Alison, Bunzli, Samantha, Smith, Anne, Lengkong, Vincent, Crossley, Kay, Kemp, Joanne, Pithie, Mia, Cochrane, Angela, Ademi, Zanfina, Hau, Raphael, Russell, Trevor, Wallis, Jason, Taylor, Nicholas, Dowsey, Michelle, Roos, Ewa, Ackerman, Ilana, Wong Shee, Anna |
| Rok vydání: |
2022 |
| Předmět: |
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| DOI: |
10.17605/osf.io/8sf9q |
| Popis: |
Osteoarthritis (OA) is the second most common chronic condition in people attending general practice in Australia and affects approximately half (50%) of people aged 65 years and over. Current data indicates that people with knee OA are three times more likely to be referred by their general practitioner for orthopaedic opinion than to allied health professionals to support first-line care such as education, exercise-therapy and weight management where indicated. Most people with knee OA do not access appropriate first-line care, and the number of total knee replacements due to knee OA has significantly increased since 2003 by approximately 150%. It is estimated the annual cost to the Australian healthcare system will exceed $3.5B by 2030. Most people accessing orthopaedic opinion at Australian public hospitals wait more than 6-months for assessment. Understanding the course of symptoms, alongside healthcare utilisation and how to optimise this, of people with knee OA referred for orthopaedic opinion at public hospitals over time is necessary to develop optimal treatments and care pathways. This project will involve two related parts. Part A will involve a large cohort of people with knee OA referred to Victorian public hospitals. Part B will involve providing improved access to appropriate first-line care to a subset of participants in Part A. Improved access will involve provision of timely care in community settings, and additional funding to reduce ‘out of pocket costs’ acting as a barrier to accessing appropriate first-line care. Our aims are listed below: Part A primary aim: Evaluate the number of people with knee OA referred to Victorian public hospitals being waitlisted for, undergoing, or desiring TKR at 4- 8- 12- (primary time point) 24- and 60-months following referral for orthopaedic opinion. Part A secondary aims: i) Evaluate the health trajectory (knee pain and quality of life) of people with knee OA referred to Victorian public hospitals at five different timepoints (4- 8- 12- 24- and 60-months). ii) Explore factors that may explain health trajectories of people with knee OA referred to Victorian public hospitals. Part B primary aim: Evaluate the effect of improved access to appropriate first-line care in the community on the proportion of people with knee OA, being waitlisted for, undergoing, or desiring TKR, compared to usual tertiary hospital care pathways at 4-, 8-, 12- (primary time point), 24- and 60-months following referral to orthopaedic opinion. Part B secondary aims i) Evaluate the effect of improved access to appropriate first-line care in the community on knee pain and quality of life outcomes in people with knee OA compared to usual tertiary hospital care pathways. ii) Evaluate cost-utility and cost-effectiveness of improved access to appropriate first line care in the community compared to usual tertiary hospital care pathways in people with knee OA referred to Victorian public hospitals. iii) Complete a comprehensive mixed-methods process evaluation involving participants, health professionals delivering care, and health service administrators to understand factors influencing the reach, effectiveness, adoption, implementation, and maintenance of the community-based first-line care intervention implemented. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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