Analysis of the Cost-Effectiveness of Same-day Discharge Surgery for Primary Total Hip Arthroplasty

NCT04900181 | Unknown

• 1 other identifier: 271816
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

Total hip arthroplasty (THA) causes a great medical burden globally, and the same-day discharge (SDD) method has previously been considered to be cost saving. However, a standard cost-effectiveness analysis (CEA) in a randomized controlled trial (RCT) is needed to evaluated the benefits of SDD when performing THA from the perspective of both economic and clinical outcomes. So the objective is to evaluate the cost-effectiveness of SDD for hip replacement. This was a single center, pragmatic RCT with a 6-month follow up. Eighty-four participants who met the inclusion criteria were randomized to either the SDD group or the inpatient group (42 per group). Outcomes were assessed by an independent orthopedist who was not in the surgical team, using the Oxford Hip Score (OHS), EuroQol 5D (EQ-5D) and 36-Item Short-From Health Survey (SF-36) scores at the baseline and the 6-month follow up. All interviews were conducted face to face. All the cost information was collected both from payment receipts and insurance reimbursement records.

Conditions

Hip Arthropathy

Keywords

same-day discharge surgery; total hip arthropathy; cost effectiveness

Outcome Measures

Primary Outcomes (1)

• the Oxford Hip Score

  the Oxford Hip Score consists of 12 questions reflecting the different aspects of hip function. Each question was scored from 0 to 4, with 4 representing the best outcome or least symptoms

  six months

Secondary Outcomes (1)

• the quality-adjusted life years

  six months

Study Arms (2)

the same-day discharge surgery

EXPERIMENTAL

Patients in the the same-day discharge surgery group were admitted to hospital, operated and discharged within 24 hour

Procedure: the same-day discharge surgery

inpatient surgery

NO INTERVENTION

Patients in inpatient surgery follow routine procedures and do not need to be discharged on the same day.

Interventions

the same-day discharge surgery PROCEDURE

the same-day discharge surgery is the procedure in which the patient is admitted, operated and discharged within 24 hours.

the same-day discharge surgery

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• undergoing unilateral primary THA
• having the ability to understand the relevant treatment process
• aged between 18 and 75 years
• a body mass index (BMI) ≤ 40 kg/m2
• hemoglobin ≥ 12g/dL
• American Society of Anesthesiologists (ASA) physical status classification of I or II
• no ongoing infection or blood coagulation disorders

You may not qualify if:

• with a history of coronary artery disease
• chronic obstructive pulmonary disease
• arrhythmias
• untreated obstructive sleep apnea

Sponsors & Collaborators

• Union Hospital, Tongji Medical College, Huazhong University of Science and Technology: lead

Study Sites (1)

Wuhan Union Hospital

Wuhan, Hubei, 430000, China

RECRUITING

Related Publications (5)

• Kurtz SM, Ong KL, Lau E, Bozic KJ. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021. J Bone Joint Surg Am. 2014 Apr 16;96(8):624-30. doi: 10.2106/JBJS.M.00285.

  PMID: 24740658 RESULT

• Molloy IB, Martin BI, Moschetti WE, Jevsevar DS. Effects of the Length of Stay on the Cost of Total Knee and Total Hip Arthroplasty from 2002 to 2013. J Bone Joint Surg Am. 2017 Mar 1;99(5):402-407. doi: 10.2106/JBJS.16.00019.

  PMID: 28244911 RESULT

• Navathe AS, Troxel AB, Liao JM, Nan N, Zhu J, Zhong W, Emanuel EJ. Cost of Joint Replacement Using Bundled Payment Models. JAMA Intern Med. 2017 Feb 1;177(2):214-222. doi: 10.1001/jamainternmed.2016.8263.

  PMID: 28055062 RESULT

• Doran JP, Zabinski SJ. Bundled payment initiatives for Medicare and non-Medicare total joint arthroplasty patients at a community hospital: bundles in the real world. J Arthroplasty. 2015 Mar;30(3):353-5. doi: 10.1016/j.arth.2015.01.035. Epub 2015 Jan 23.

  PMID: 25680450 RESULT

• Zeng JQ. The pilot results of 47 148 cases of BJ-DRGs-based payment in China. Int J Health Plann Manage. 2019 Oct;34(4):1386-1398. doi: 10.1002/hpm.2818. Epub 2019 Jul 8.

  PMID: 31286577 RESULT

Related Links

• The link of citation

Study Officials

• Hongtao Tian, doctor

  Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

  STUDY DIRECTOR

Central Study Contacts

Hongtao Tian, doctor

CONTACT

18627171618; tianhongtao@vip.163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 29, 2021
• First Posted: May 25, 2021
• Study Start: July 1, 2020
• Primary Completion: July 1, 2021
• Study Completion: July 15, 2021
• Last Updated: May 25, 2021

Record last verified: 2021-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)