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Preoperative patients' health decrease moderately, while hospital costs increase for hip and knee replacement due to

Caroline Schatz1,2, Reiner Leidl3,4, Werner Plötz5,6

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The COVID-19 lockdown slightly worsened osteoarthritis patient health before hip and knee replacements, while increasing hospital costs. Length of stay was reduced.

Keywords:
COVID-19CostHealth-related quality of lifeJoint replacementOsteoarthritis

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Area of Science:

  • Orthopedics
  • Health Economics
  • Epidemiology

Background:

  • The COVID-19 pandemic and associated lockdowns significantly impacted healthcare systems globally.
  • Elective surgeries, including hip and knee replacements for osteoarthritis, faced disruptions and potential delays.
  • Changes in patient health status and hospital costs during this period require investigation.

Purpose of the Study:

  • To compare the preoperative health status and inpatient hospital costs of osteoarthritis patients undergoing primary hip and knee replacements before, during, and after the first COVID-19 lockdown in Germany.
  • To assess the impact of lockdown measures on patient outcomes and healthcare expenditures.

Main Methods:

  • Retrospective cohort study including 852 patients undergoing primary hip or knee replacement at a German hospital.
  • Preoperative health assessed using the WOMAC Score and EQ-5D-5L.
  • Inpatient hospital unit costs calculated using standardized methods.
  • Statistical analysis employed Kruskal-Wallis and Chi-squared tests.

Main Results:

  • A slight worsening in preoperative health status was observed post-lockdown, as indicated by higher WOMAC Scores (p < 0.01).
  • No significant difference in EQ-5D-5L scores was found related to lockdown status.
  • Length of hospital stay decreased by approximately one day (p < 0.001).
  • Total inpatient hospital unit costs per patient per day significantly increased during and after the lockdown (p < 0.001).

Conclusions:

  • Preoperative health status, measured by WOMAC Score, slightly declined after the initial COVID-19 lockdown compared to the pre-lockdown period.
  • The EQ-5D-5L indicated no significant change in preoperative health.
  • Inpatient hospital unit costs experienced a significant rise during the COVID-19 pandemic.