Economic Evaluation of Access to Musculoskeletal Care
Economic Evaluation of Access to Musculoskeletal Care
Total knee arthroplasty (TKA) is an effective treatment to alleviate pain and improve physical functioning in patients with arthritic knees. Approximately 300,000 TKAs are performed in the United States each year making it an exceptionally common surgical procedure. As the population continues to age, the demand for primary TKAs is projected to increase 673% by 2030. Others have projected significant workforce shortages poised to meet this growing demand. Undoubtedly, great challenges about how to narrow this gap in supply and demand are upon us.
Strategies to meet this demand include workforce increases, operational efficiency gains and minimizing revisions. However, experience from other developed countries as well as the U.S. Veterans Administration Hospital system suggest wait times will increase rapidly as demand rises. The current mean wait time for TKA in Canada is 237 days and the mean wait time for TKA within the Veterans Affairs Healthcare System in the United States can be as long as two years. In particular the wait time in Canada has grown by 423% since the mid-1990s. Furthermore, increased waiting time for TKA has the potential to negatively impact patient outcome. Wait times longer than 6 months may reduce health-related quality of life and increase contralateral knee pain 6 months after TKA.
TKA is known to be a cost-effective treatment across populations in the United States and abroad. Furthermore, end-stage arthritis is associated with high direct medical costs and healthcare resource utilization. However, the societal economic impact of wait times for elective procedures remains unclear. A complete understanding of the entire care pathway of end-stage OA is necessary to direct policymaking and optimizes resource allocation. Using the power of decision analysis, the purpose of this study was to explore the societal economic impact of wait times for primary TKA.
Background
Total knee arthroplasty (TKA) is an effective treatment to alleviate pain and improve physical functioning in patients with arthritic knees. Approximately 300,000 TKAs are performed in the United States each year making it an exceptionally common surgical procedure. As the population continues to age, the demand for primary TKAs is projected to increase 673% by 2030. Others have projected significant workforce shortages poised to meet this growing demand. Undoubtedly, great challenges about how to narrow this gap in supply and demand are upon us.
Strategies to meet this demand include workforce increases, operational efficiency gains and minimizing revisions. However, experience from other developed countries as well as the U.S. Veterans Administration Hospital system suggest wait times will increase rapidly as demand rises. The current mean wait time for TKA in Canada is 237 days and the mean wait time for TKA within the Veterans Affairs Healthcare System in the United States can be as long as two years. In particular the wait time in Canada has grown by 423% since the mid-1990s. Furthermore, increased waiting time for TKA has the potential to negatively impact patient outcome. Wait times longer than 6 months may reduce health-related quality of life and increase contralateral knee pain 6 months after TKA.
TKA is known to be a cost-effective treatment across populations in the United States and abroad. Furthermore, end-stage arthritis is associated with high direct medical costs and healthcare resource utilization. However, the societal economic impact of wait times for elective procedures remains unclear. A complete understanding of the entire care pathway of end-stage OA is necessary to direct policymaking and optimizes resource allocation. Using the power of decision analysis, the purpose of this study was to explore the societal economic impact of wait times for primary TKA.
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