Authors' objectives:

To present and analyse the factors that influence the variability of this procedure (hip prosthetic replacement), in both utilisation rates and in the measure of the degree of involvement of the arthropathy and in the operation outcomes, in the selection of implants and its cost, and in the actual efficiency with which hip prosthetic replacement is performed.

Authors' recommendations: Surgical indication, based on symptoms and on its impact on the patients quality of life, should be standardised with simple validated tools addressing the degrees of involvement, progression and, afterwards, improvement derived from the operation. This type of tools can be used when prioritising the intervention to patients where a greater benefit could be achieved, since no criteria has been found that may rationalise the waiting lists that can be found in countries with public universal coverage. The three items which better determine the total cost of hip prosthetic replacement are, at a short term, cost of the prosthesis and hospital stay, and at a mid-long term, the revision surgery rates. Selection of the prosthetic material should be based on the available data on its survival and cost, as decided by a prosthesis committee, presenting clinical and implant data for a new multicenter arthroplasty registry to be implemented, in line with the proposals of the Catalan Society of Orthopaedic Surgery and Traumatology. Professionals should be involved in measures that, from the critical pathways analysis of the health care process, would allow for a more efficient use of resources. Policies regarding prosthetic material distributors should be addressed at reducing the range of models within each class, basing the selection on effectiveness (long term implant survival) and cost. Any other newly introduced prosthesis, or without available long term results should be considered only within a research and register protocol, or a multicenter assessment.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.gencat.net/salut/depsan/units/aatrm/html/en/dir393/doc7921.ht ml

Year Published: 1999

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Qualitat i Avaluacio Sanitries de Catalunya

Contact Address: Antoni Parada, CAHTA, Roc Boronat, 81-95 (2nd floor), 08005 Barcelona, Spain, Tel. +34 935 513 928, Fax: +34 935 517 510

Contact Name: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Contact Email: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Copyright: Catalan Agency for Health Technology Assessment and Research