Economic outcomes from patients' perspective and health-related quality of life after total hip arthroplasty

The aim of this study was to determine the economic outcomes (service use, health care and nonhealth care out-of-pocket costs) related to total hip arthroplasty from the perspective of patients. Also, examined was the relationship between economic outcomes and health-related quality of life (HRQOL). One hundred patients, 54 female and 46 male, mean age 63.9 (SD 11.6) years, with osteoarthritis in the hip and undergoing primary or revision arthroplasty, participated in this follow-up study. The drop-out race was 13%. Patients' service use, and out-of-pocket costs were recorded, and HRQOL was measured up to 6 months. The Friedman and Wilcoxon nonparametric tests showed that use of home nursing and transportation was most frequent at 1 month, whereas physiotherapy was used most often after 1 month. The Spearman coefficient of correlation, Fisher's, Mann-Whitney U and Kruskal-Wallis tests were used to compare background factors with economic outcomes and HRQOL. Age, pain, gender, civil status, type of surgery and discharge destination showed associations with service use. Healthcare costs composed over 90% of total out-of-pocket costs, and nonhealthcare costs < 10%. Age and discharge destination were related to total out-of-pocket costs. Patients' HRQOL improved after surgery. The worse it was before, or after surgery, the more services were used, but no significant correlations between costs and HRQOL were observed. When deciding the timing of surgery, patients' characteristics, especially level of pain and HRQOL should carefully evaluated, as they may predict patients' service use and ability to manage at home after surgery.