Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care in the Netherlands versus Germany

Annet Wijnen, Gesine Heber, Günter Dietz, Baukje Dijkstra, Johan S. Dekker, Karin M. Vermeulen, Geranda Slager, Aike Hessel, Djordje Lazovic, Sjoerd K. Bulstra, Martin Stevens

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    Abstract

    Background
    Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.

    Methods
    A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.

    Results
    124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.

    Conclusions
    German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.
    Translated title of the contributionEffecten van revalidatie van werkende patiënten na een totale heup artroplastiek: een vergelijking van de usual care tussen Nederland en Duitsland
    Original languageEnglish
    Article number525 (2023)
    JournalBMC Musculoskeletal Disorders
    Volume24
    DOIs
    Publication statusPublished - 27 Jun 2023

    Keywords

    • effectiveness
    • rehabilitation
    • working-class patients
    • total hip arthroplasty
    • usual care

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