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Text
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<a href="http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x</a>
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Title
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In the queue for total joint replacement: patients' perspectives on waiting times
Publisher
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Journal Of Evaluation In Clinical Practice
Date
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1997
Subject
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Arthroplasty; Hip; Hip Prosthesis; Joint Prosthesis; Knee; Replacement; Time Management; Waiting Lists
Creator
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Llewellyn-Thomas HA; Arshinoff R; Bell M; Williams JI; Naylor CD; the Ontario Hip; Knee Replacement Project Team
Description
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We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P=0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z=2.951; P=0.004) and shorter times since their surgeon first advised them of the need for surgery (z=3.014; P=0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.
1997
Identifier
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<a href="http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x" target="_blank" rel="noreferrer">10.1046/j.1365-2753.1998.t01-1-00006.x</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
1997
Arshinoff R
Arthroplasty
Backlog
Bell M
Hip
Hip Prosthesis
Joint Prosthesis
Journal Article
Journal Of Evaluation In Clinical Practice
Knee
Knee Replacement Project Team
Llewellyn-Thomas HA
Naylor CD
Replacement
the Ontario Hip
Time Management
Waiting Lists
Williams JI