The journey to total hip or knee replacement

Area of Science:

• Orthopaedic surgery pathway analysis
• Health services research

Background:

• Limited understanding of patient progression from referral to joint replacement surgery in Australia.
• Joint replacement incidence is high, necessitating clear pathway data.

Purpose of the Study:

• To describe the patient pathway from referral to total hip replacement (THR) or total knee replacement (TKR) surgery.
• To identify and analyze the distinct phases of the patient journey in South Australian public hospitals.

Main Methods:

• Postal survey of 450 patients undergoing THR or TKR.
• Semi-structured interviews with 19 hospital employees.
• Descriptive statistical analysis of survey data and thematic analysis of interview data.

Main Results:

• The patient pathway comprises two phases: referral-to-initial appointment (9-24 months) and initial appointment-to-surgery (12-15 months).
• Overall waiting times for THR or TKR surgery range between 2 and 3 years.
• Reported waiting times exceed those in existing literature.

Conclusions:

• Current Australian health policy inadequately addresses the lengthy initial referral phase of the patient pathway.
• Excluding the referral-to-initial appointment phase may lead to inaccurate perceptions of total waiting times.
• This could result in flawed health reforms for joint replacement surgery access.