Quality of life, disabiilty and prioritisation of people waiting for joint replacement surgery

Clinical Epidemiology - Cabrini

A/Prof Rachelle Buchbinder, Dr Richard Osborne, Dr Catherine Hill, Prof Stephen Graves, Mr Max Esser, Mr Michael Fogarty, Mr John Griffiths, Mr Adrian Trivett, Mr Harry Tsigaris, Mr Shay Zayontz, Ms Lainie Wengier

Osteoarthritis (OA) is one of the most common chronic diseases in modern society. Orthopaedic surgery for progressive OA is a 'last resort' management option used when more conservative treatments no longer control the symptoms. The ideal time for surgery is a crucial parameter that remains to be defined. When placed on a public hospital waiting list, patients are ascribed a category, which indicates the urgency of treatment. This system is subjective and based on the treating surgeon's opinion at the time the patient is added to the list. Additionally there is no formal mechanism to detect a worsening clinical picture, and it is clinically evident that some patients do deteriorate while waiting for surgery. In Australia there have been no studies undertaken to determine the extent of this problem.

The New Zealand Priority Criteria (NZPC) comprises a weighted scoring system that includes clinical indications, function and social factors to prioritise joint replacement for patients in New Zealand. It was developed in the hope that it will promote better care and accountability in a publicly funded health care system. This study will provide Australian data on the utility of the NZPC and will provide disease-specific data and standardized generic data on the wellbeing of people requiring joint replacements and permit insights into whether the NZPC can promote better care and accountability in health care.