{"id":5988,"date":"2009-07-01T00:00:00","date_gmt":"2009-07-01T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/a-population-based-nested-case-control-study-of-the-costs-of-hip-and-knee-replacement-surgery\/"},"modified":"2023-06-14T19:30:24","modified_gmt":"2023-06-14T23:30:24","slug":"a-population-based-nested-case-control-study-of-the-costs-of-hip-and-knee-replacement-surgery","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/a-population-based-nested-case-control-study-of-the-costs-of-hip-and-knee-replacement-surgery\/","title":{"rendered":"A population-based nested case-control study of the costs of hip and knee replacement surgery"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Studies of total joint arthroplasty (TJA) have not evaluated the costs and outcomes in the context of expected arthritis worsening.<\/p>\n<p><strong>Objectives<\/strong> &#x2014; Using a cost-consequence approach, to examine changes in direct healthcare costs and arthritis severity after TJA for hip\/knee arthritis compared with contemporaneous changes in matched controls.<\/p>\n<p><strong>Research Design<\/strong> &#x2014; Case control study nested in a population-based prospective cohort.<\/p>\n<p><strong>Subjects<\/strong> &#x2014; In a population cohort with disabling hip\/knee osteoarthritis followed from 1996 to 2003, primary TJA recipients were matched with cohort nonrecipients on age, sex, region of residence, comorbidity, and inflammatory arthritis diagnosis.<\/p>\n<p><strong>Measures<\/strong> &#x2014; Pre- and postoperative total and arthritis-attributable direct healthcare costs, arthritis severity, and general health status were compared for cases and matched controls.<\/p>\n<p><strong>Results<\/strong> &#x2014; Of 2109 participants with no prebaseline TJA, 185 cases received a single elective TJA during the follow-up period; of these, 183 cases and controls were successfully matched. Mean age was 71 years, 77.6% were female, 35.5% had &#x2265;2 comorbidities, and 81.5% had &#x2265;2 joints affected. At baseline, controls had less pain and disability and lower total and arthritis-attributable healthcare costs than cases. After surgery, although overall healthcare utilization was unchanged, cases experienced significant decreases in arthritis-attributable costs (mean decrease &#x24;278 including prescription drugs) and pain and disability (P &lt; 0.0001 for all). Over the same time period, controls experienced a significant increase in total healthcare costs (mean increase &#x24;1978 including prescription drugs, P = 0.04) and no change or worsening of their arthritis status.<\/p>\n<p><strong>Conclusion<\/strong> &#x2014; Compared with matched controls, arthroplasty is associated with significant reductions in pain, disability, and arthritis-attributable direct costs.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Studies of total joint arthroplasty (TJA) have not evaluated the costs and outcomes in the context of expected arthritis worsening. Objectives &#x2014; Using a cost-consequence approach, to examine changes in direct healthcare costs and arthritis severity after TJA for hip\/knee arthritis compared with contemporaneous changes in matched controls. Research Design &#x2014; Case control [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[61,25],"migration-helper-qa-sample-set":[],"class_list":["post-5988","journal_article","type-journal_article","status-publish","hentry","topic-health-economics","topic-surgery"],"acf":{"citation":"Hawker GA, Badley EM, Croxford R, Coyte PC, Glazier RH, Guan J, Harvey BJ, Williams JI, Wright JG. <em>Med Care<\/em>. 2009; 47(7):732-41.","source_url":"","ices_scientist":[1267,1173,1250,1134],"site":[6735,6733],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"3FD2F6D0-1C2E-4458-BCD6-37D04AEC637C","sitecore_item_name":"A-population-based-nested-case-control-study-of-the-costs-of-hip-and-knee-replacement-surgery","sitecore_field_values":"{\n  \"Title\": \"A population-based nested case-control study of the costs of hip and knee replacement surgery\",\n  \"Short title\": \"A population-based nested case-control\",\n  \"Citation\": \"<p>Hawker GA, Badley EM, Croxford R, Coyte PC, Glazier RH, Guan J, Harvey BJ, Williams JI, Wright JG. <em>Med Care<\/em>. 2009; 47(7):732-41.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Studies of total joint arthroplasty (TJA) have not evaluated the costs and outcomes in the context of expected arthritis worsening.<\/p>rn<p><strong>Objectives<\/strong> &mdash; Using a cost-consequence approach, to examine changes in direct healthcare costs and arthritis severity after TJA for hip\/knee arthritis compared with contemporaneous changes in matched controls.<\/p>rn<p><strong>Research Design<\/strong> &mdash; Case control study nested in a population-based prospective cohort.<\/p>rn<p><strong>Subjects<\/strong> &mdash; In a population cohort with disabling hip\/knee osteoarthritis followed from 1996 to 2003, primary TJA recipients were matched with cohort nonrecipients on age, sex, region of residence, comorbidity, and inflammatory arthritis diagnosis.<\/p>rn<p><strong>Measures<\/strong> &mdash; Pre- and postoperative total and arthritis-attributable direct healthcare costs, arthritis severity, and general health status were compared for cases and matched controls.<\/p>rn<p><strong>Results<\/strong> &mdash; Of 2109 participants with no prebaseline TJA, 185 cases received a single elective TJA during the follow-up period; of these, 183 cases and controls were successfully matched. Mean age was 71 years, 77.6% were female, 35.5% had &ge;2 comorbidities, and 81.5% had &ge;2 joints affected. At baseline, controls had less pain and disability and lower total and arthritis-attributable healthcare costs than cases. After surgery, although overall healthcare utilization was unchanged, cases experienced significant decreases in arthritis-attributable costs (mean decrease $278 including prescription drugs) and pain and disability (P &lt; 0.0001 for all). Over the same time period, controls experienced a significant increase in total healthcare costs (mean increase $1978 including prescription drugs, P = 0.04) and no change or worsening of their arthritis status.<\/p>rn<p><strong>Conclusion<\/strong> &mdash; Compared with matched controls, arthroplasty is associated with significant reductions in pain, disability, and arthritis-attributable direct costs.<\/p>\",\n  \"Keywords\": \"{F7768D98-9C4F-47E5-989E-ACA10F786A73}|{5B386094-8417-4B93-9D08-2F46BC0458AB}\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}|{5B1AF319-EC9B-4BF0-A9CD-D066ABE49D71}\",\n  \"ICES Locations\": \"{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}|{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{4D93CE4E-174C-4555-9897-9FAE06C5C9CE}|{FDF484CC-2616-4FCE-88F8-5CBD62244BF2}|{2C81C93C-B401-432B-8741-83841744D4CA}|{BAE8C689-AC7A-45F8-BFA6-7494B4DC885F}\",\n  \"Posted Date\": \"20090701T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2009\/January\/A-population-based-nested-case-control-study-of-the-costs-of-hip-and-knee-replacement-surgery"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | A population-based nested case-control study of the costs of hip and knee replacement surgery<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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