1 Department of Business and Management, The Faculty of Social Sciences, Aalborg University, VBN2 Danish Center for Healthcare Improvements, The Faculty of Social Sciences, Aalborg University, VBN3 The Faculty of Social Sciences, Aalborg University, VBN4 Aarhus University Hospital5 Aarhus University6 Aarhus University
Background: Total hip replacement (THR) is an effective, but also cost-intensive health care procedure for the elderly. Because of demographic changes in Western Europe, THR-associated financial investment for health care has become a question of priorities in society. To provide a quantitative rationale for a discussion within Western European health care systems, we undertook a prospective assessment of the benefit of THR from the patients´ perspective and as measured by quality-adjusted life years (QALYs). Aim: To measure the difference in health related quality of life between an intervention and control group preoperatively and at follow-up 9 months after THR. Methods: A randomised clinical trial allocating 180 patients aged over 65 years to either an intervention group or a control group. The control group received conventional treatment and the intervention group received both conventional treatment and telephone intervention. QALYs were calculated from measures of health-related quality of life using questionnaire SF-36. These scores were transformed to QALYs using a formula based on the method developed by Brazier (Brazier 1998). Results: Both the control and the intervention patients reported significant changes in quality adjusted life years from preoperative status to 3 and 9 months after surgery. Patients in the interventions group had a significantly higher raise in qualy from baseline to 3 months after surgery. Interpretation: There was a significant gain in QALYs in both groups. However, no significant or clinically relevant differences between the two groups were observed at follow-up within this timeframe.
International Journal of Orthopaedic and Trauma Nursing, 2011, Vol 15, Issue 1, p. 11-17