Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2022

24.02.2022 | COVID-19 | KNEE

Preoperative patients’ health decrease moderately, while hospital costs increase for hip and knee replacement due to the first COVID-19 lockdown in Germany

verfasst von: Caroline Schatz, Reiner Leidl, Werner Plötz, Katharina Bredow, Peter Buschner

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was a comparison between osteoarthritis patients with primary hip and knee replacements before, during and after the first COVID-19 lockdown in Germany. Patients’ preoperative health status is assumed to decrease, owing to delayed surgeries. Costs for patients with osteoarthritis were assumed to increase, for example, due to higher prices for protective equipment. Hence, a comparison of patients treated before, during and after the first lockdown is conducted.

Methods

In total, 852 patients with primary hip or knee replacement were included from one hospital in Germany. Preoperative health status was measured with the WOMAC Score and the EQ-5D-5L. Hospital unit costs were calculated using a standardised cost calculation. Kruskal–Wallis tests and Chi-squared tests were applied for the statistical analyses.

Results

The mean of the preoperative WOMAC Score was slightly higher (p < 0.01) for patients before the first lockdown, compared with patients afterwards. Means of the EQ-5D-5L were not significantly different regarding the lockdown status (NS). Length of stay was significantly reduced by approximately 1 day (p < 0.001). Total inpatient hospital unit costs per patient and per day were significantly higher for patients during and after the first lockdown (p < 0.001).

Conclusion

Preoperative health, measured with the WOMAC Score, worsened slightly for patients after the first lockdown compared with patients undergoing surgery before COVID-19. Preoperative health, measured using the EQ-5D-5L, was unaffected. Inpatient hospital unit costs increased significantly with the COVID-19 pandemic.

Level of evidence

Retrospective cohort study, III.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Carducci MP, Gasbarro G, Menendez ME, Mahendraraj KA, Mattingly DA, Talmo C et al (2020) Variation in the cost of care for different types of joint arthroplasty. J Bone Jt Surg Am 102:404–409CrossRef Carducci MP, Gasbarro G, Menendez ME, Mahendraraj KA, Mattingly DA, Talmo C et al (2020) Variation in the cost of care for different types of joint arthroplasty. J Bone Jt Surg Am 102:404–409CrossRef
2.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRef
3.
Zurück zum Zitat Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ (2018) What is the minimum clinically important difference for the WOMAC index after TKA? Clin Orthop Relat Res 476:2005–2014CrossRef Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ (2018) What is the minimum clinically important difference for the WOMAC index after TKA? Clin Orthop Relat Res 476:2005–2014CrossRef
4.
Zurück zum Zitat Dormann CF, Elith J, Bacher S, Buchmann C, Carl G, Carré G et al (2013) Collinearity: a review of methods to deal with it and a simulation study evaluating their performance. Ecography 36:27–46CrossRef Dormann CF, Elith J, Bacher S, Buchmann C, Carl G, Carré G et al (2013) Collinearity: a review of methods to deal with it and a simulation study evaluating their performance. Ecography 36:27–46CrossRef
5.
Zurück zum Zitat Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27CrossRef Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27CrossRef
6.
Zurück zum Zitat Endstrasser F, Braito M, Linser M, Spicher A, Wagner M, Brunner A (2020) The negative impact of the COVID-19 lockdown on pain and physical function in patients with end-stage hip or knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 28:2435–2443CrossRef Endstrasser F, Braito M, Linser M, Spicher A, Wagner M, Brunner A (2020) The negative impact of the COVID-19 lockdown on pain and physical function in patients with end-stage hip or knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 28:2435–2443CrossRef
7.
Zurück zum Zitat Felix J, Becker C, Vogl M, Buschner P, Plötz W, Leidl R (2019) Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty—results from a German prospective cohort study. Health Qual Life Outcomes 17:180CrossRef Felix J, Becker C, Vogl M, Buschner P, Plötz W, Leidl R (2019) Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty—results from a German prospective cohort study. Health Qual Life Outcomes 17:180CrossRef
8.
Zurück zum Zitat Gasparini, (2018) comorbidity: an R package for computing comorbidity scores. J Open Source Softw 3:648–651CrossRef Gasparini, (2018) comorbidity: an R package for computing comorbidity scores. J Open Source Softw 3:648–651CrossRef
9.
Zurück zum Zitat Gastwirth J, Gel Y, Miao W (2010) The impact of Levene’s test of equality of variances on statistical theory and practice. Stat Sci 24:343–360 Gastwirth J, Gel Y, Miao W (2010) The impact of Levene’s test of equality of variances on statistical theory and practice. Stat Sci 24:343–360
11.
Zurück zum Zitat Knebel C, Ertl M, Lenze U, Suren C, Dinkel A, Hirschmann MT et al (2021) COVID-19-related cancellation of elective orthopaedic surgery caused increased pain and psychosocial distress levels. Knee Surg Sports Traumatol Arthrosc 29:2379–2385CrossRef Knebel C, Ertl M, Lenze U, Suren C, Dinkel A, Hirschmann MT et al (2021) COVID-19-related cancellation of elective orthopaedic surgery caused increased pain and psychosocial distress levels. Knee Surg Sports Traumatol Arthrosc 29:2379–2385CrossRef
12.
Zurück zum Zitat Kort NP, Barrena EG, Bédard M, Donell S, Epinette JA, Gomberg B et al (2020) Resuming elective hip and knee arthroplasty after the first phase of the SARS-CoV-2 pandemic: the European Hip Society and European Knee Associates recommendations. Knee Surg Sports Traumatol Arthrosc 28:2730–2746CrossRef Kort NP, Barrena EG, Bédard M, Donell S, Epinette JA, Gomberg B et al (2020) Resuming elective hip and knee arthroplasty after the first phase of the SARS-CoV-2 pandemic: the European Hip Society and European Knee Associates recommendations. Knee Surg Sports Traumatol Arthrosc 28:2730–2746CrossRef
13.
Zurück zum Zitat Kruskal WH, Wallis WA (1952) Use of ranks in one-criterion variance analysis. J Am Stat Assoc 47:583–621CrossRef Kruskal WH, Wallis WA (1952) Use of ranks in one-criterion variance analysis. J Am Stat Assoc 47:583–621CrossRef
14.
Zurück zum Zitat Larghi MM, Grassi M, Luca F, Placenza E, Rampulla C, Manzotti A (2020) Clinical outcome before and after COVID-19 quarantine in patients affect of knee and hip osteoarthritis. Acta Biomed 91:e2020150PubMedPubMedCentral Larghi MM, Grassi M, Luca F, Placenza E, Rampulla C, Manzotti A (2020) Clinical outcome before and after COVID-19 quarantine in patients affect of knee and hip osteoarthritis. Acta Biomed 91:e2020150PubMedPubMedCentral
15.
Zurück zum Zitat Leidl R, Reitmeir P (2017) An experience-based value set for the EQ-5D-5L in Germany. Value Health 20:1150–1156CrossRef Leidl R, Reitmeir P (2017) An experience-based value set for the EQ-5D-5L in Germany. Value Health 20:1150–1156CrossRef
16.
Zurück zum Zitat Menendez ME, Neuhaus V, Ring D (2015) Inpatient mortality after orthopaedic surgery. Int Orthop 39:1307–1314CrossRef Menendez ME, Neuhaus V, Ring D (2015) Inpatient mortality after orthopaedic surgery. Int Orthop 39:1307–1314CrossRef
17.
Zurück zum Zitat Palsis JA, Brehmer TS, Pellegrini VD, Drew JM, Sachs BL (2018) The cost of joint replacement: comparing two approaches to evaluating costs of total hip and knee arthroplasty. J Bone Jt Surg Am 100:326–333CrossRef Palsis JA, Brehmer TS, Pellegrini VD, Drew JM, Sachs BL (2018) The cost of joint replacement: comparing two approaches to evaluating costs of total hip and knee arthroplasty. J Bone Jt Surg Am 100:326–333CrossRef
20.
Zurück zum Zitat Saklad M (1941) Grading of patients for surgical procedures. Anesthesiology 2:281–284CrossRef Saklad M (1941) Grading of patients for surgical procedures. Anesthesiology 2:281–284CrossRef
21.
Zurück zum Zitat Scott CEH, MacDonald DJ, Howie CR (2019) “Worse than death” and waiting for a joint arthroplasty. Bone Jt J 101-b:941–950CrossRef Scott CEH, MacDonald DJ, Howie CR (2019) “Worse than death” and waiting for a joint arthroplasty. Bone Jt J 101-b:941–950CrossRef
22.
Zurück zum Zitat Shapiro SS, Wilk MB (1965) An analysis of variance test for normality (complete samples). Biometrika 52:591–611CrossRef Shapiro SS, Wilk MB (1965) An analysis of variance test for normality (complete samples). Biometrika 52:591–611CrossRef
23.
Zurück zum Zitat Singh J, Sloan JA, Johanson NA (2010) Challenges with health-related quality of life assessment in arthroplasty patients: problems and solutions. J Am Acad Orthop Surg 18:72–82CrossRef Singh J, Sloan JA, Johanson NA (2010) Challenges with health-related quality of life assessment in arthroplasty patients: problems and solutions. J Am Acad Orthop Surg 18:72–82CrossRef
24.
Zurück zum Zitat Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM et al (2019) Minimal clinically important decline in physical function over one year: EPOSA study. BMC Musculoskelet Disord 20:227CrossRef Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM et al (2019) Minimal clinically important decline in physical function over one year: EPOSA study. BMC Musculoskelet Disord 20:227CrossRef
25.
Zurück zum Zitat Stargardt T (2008) Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries. Health Econ 17:S9-20CrossRef Stargardt T (2008) Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries. Health Econ 17:S9-20CrossRef
26.
Zurück zum Zitat Venables WN, Ripley BD (2002) Modern applied statistics with S. Springer, New YorkCrossRef Venables WN, Ripley BD (2002) Modern applied statistics with S. Springer, New YorkCrossRef
27.
Zurück zum Zitat Vogl M (2012) Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany. Health Econ Rev 2:15CrossRef Vogl M (2012) Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany. Health Econ Rev 2:15CrossRef
28.
Zurück zum Zitat Vogl M, Wilkesmann R, Lausmann C, Hunger M, Plötz W (2014) The impact of preoperative patient characteristics on health states after total hip replacement and related satisfaction thresholds: a cohort study. Health Qual Life Outcomes 12:108CrossRef Vogl M, Wilkesmann R, Lausmann C, Hunger M, Plötz W (2014) The impact of preoperative patient characteristics on health states after total hip replacement and related satisfaction thresholds: a cohort study. Health Qual Life Outcomes 12:108CrossRef
29.
Zurück zum Zitat von Dercks N, Körner C, Heyde C-E, Theopold J (2020) How badly is the coronavirus pandemic affecting orthopaedic and trauma surgery clinics?: an analysis of the first 5 weeks. Orthopade 49:494–501CrossRef von Dercks N, Körner C, Heyde C-E, Theopold J (2020) How badly is the coronavirus pandemic affecting orthopaedic and trauma surgery clinics?: an analysis of the first 5 weeks. Orthopade 49:494–501CrossRef
30.
Zurück zum Zitat von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457CrossRef
31.
Zurück zum Zitat Xiang B, Li P, Yang X, Zhong S, Manyande A, Feng M (2020) The impact of novel coronavirus SARS-CoV-2 among healthcare workers in hospitals: an aerial overview. Am J Infect Control 48:915–917CrossRef Xiang B, Li P, Yang X, Zhong S, Manyande A, Feng M (2020) The impact of novel coronavirus SARS-CoV-2 among healthcare workers in hospitals: an aerial overview. Am J Infect Control 48:915–917CrossRef
32.
Zurück zum Zitat Zeileis A (2006) Object-oriented computation of sandwich estimators. J Stat Softw 16:16CrossRef Zeileis A (2006) Object-oriented computation of sandwich estimators. J Stat Softw 16:16CrossRef
33.
Zurück zum Zitat Zeileis A, Hothorn T (2002) Diagnostic checking in regression relationships. R News 2:7–10 Zeileis A, Hothorn T (2002) Diagnostic checking in regression relationships. R News 2:7–10
34.
Zurück zum Zitat Zeileis A, Köll S, Graham N (2020) Various versatile variances: an object-oriented implementation of clustered covariances in R. J Stat Softw 95:1–36CrossRef Zeileis A, Köll S, Graham N (2020) Various versatile variances: an object-oriented implementation of clustered covariances in R. J Stat Softw 95:1–36CrossRef
Metadaten
Titel
Preoperative patients’ health decrease moderately, while hospital costs increase for hip and knee replacement due to the first COVID-19 lockdown in Germany
verfasst von
Caroline Schatz
Reiner Leidl
Werner Plötz
Katharina Bredow
Peter Buschner
Publikationsdatum
24.02.2022
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06904-9

Weitere Artikel der Ausgabe 10/2022

Knee Surgery, Sports Traumatology, Arthroscopy 10/2022 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.