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.
RCT Entities:
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 osteoarthritispatients 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.
Authors: Kristin J Konnyu; Louise M Thoma; Wangnan Cao; Roy K Aaron; Orestis A Panagiotou; Monika Reddy Bhuma; Gaelen P Adam; Ethan M Balk; Dan Pinto Journal: Am J Phys Med Rehabil Date: 2022-03-12 Impact factor: 3.412
Authors: Hairil Rizal Abdullah; Niresh Ranjakunalan; William Yeo; Mann Hong Tan; Ruban Poopalalingam; Yilin Eileen Sim Journal: Qual Life Res Date: 2018-09-10 Impact factor: 4.147
Authors: Mark G Pritchard; Jacqueline Murphy; Lok Cheng; Roshni Janarthanan; Andrew Judge; Jose Leal Journal: BMJ Open Date: 2020-01-15 Impact factor: 2.692