Need-based waiting lists for hip and knee arthroplasty

Area of Science:

• Orthopaedic surgery
• Healthcare management
• Patient prioritization

Background:

• Traditional time-based waiting lists may not reflect patient need for joint replacement surgery.
• Need-based waiting lists offer potential advantages in resource allocation and patient outcomes.
• This study evaluated the impact of transitioning to a need-based system in an orthopaedic practice.

Purpose of the Study:

• To investigate the effect of introducing need-based waiting lists in an orthopaedic practice.
• To compare the outcomes of need-based versus time-based waiting lists for joint replacement procedures.
• To assess the impact on waiting list duration, efficiency, and transparency.

Main Methods:

• Patients awaiting total hip replacement (n=240) and total knee replacement (n=98) were assessed.
• A joint score (Harris Hip Score or American Knee Society Score) was calculated for each patient.
• Patients with the lowest scores were prioritized on the waiting list; scores were reassessed postoperatively.

Main Results:

• Need-based waiting lists reduced the hip replacement waiting list by 20% and the knee replacement waiting list by 11%.
• The implementation led to increased efficiency and transparency within the orthopaedic service.
• Patient prioritization based on clinical need was successfully achieved.

Conclusions:

• Need-based waiting lists are easily implemented and provide significant benefits over time-based systems.
• This approach optimizes patient flow and resource utilization in joint replacement surgery.
• Widespread adoption in other orthopaedic centers is recommended for improved patient care and service delivery.