Evidence map›Paper›PMID 36302128›Full record

Trial reportCanadian journal of surgery. Journal canadien de chirurgie

The cost of outpatient versus inpatient total hip arthroplasty: a randomized trial.

Bryn O Zomar, Jacquelyn D Marsh, Dianne M Bryant, Brent A Lanting

Registry-linked trialOpen access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03026764 (Patient Satisfaction and Costs Associated With Total Hip Arthroplasty), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03026764 nacompletednot on this map

Patient Satisfaction and Costs Associated With Total Hip Arthroplasty

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2015 to 2022Enrolled558ConditionsOsteoarthritisArmsOutpatient, Inpatient
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Cost and resource comparison analysis for THA in Switzerland and Austria.International journal of technology assessment in health care · 2024
    Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Bryn O ZomarFrom the Faculty of Health Sciences, Western University, London, Ont. (Zomar, Marsh, Bryant); the Bone and Joint Institute, Western University, London, Ont. (Zomar, Marsh, Bryant, Lanting); the Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ont. (Lanting); and the Schulich School of Medicine & Dentistry, Western University, London Ont. (Lanting).
Jacquelyn D MarshFrom the Faculty of Health Sciences, Western University, London, Ont. (Zomar, Marsh, Bryant); the Bone and Joint Institute, Western University, London, Ont. (Zomar, Marsh, Bryant, Lanting); the Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ont. (Lanting); and the Schulich School of Medicine & Dentistry, Western University, London Ont. (Lanting) jmarsh2@uwo.ca.
Dianne M BryantFrom the Faculty of Health Sciences, Western University, London, Ont. (Zomar, Marsh, Bryant); the Bone and Joint Institute, Western University, London, Ont. (Zomar, Marsh, Bryant, Lanting); the Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ont. (Lanting); and the Schulich School of Medicine & Dentistry, Western University, London Ont. (Lanting).
Brent A LantingFrom the Faculty of Health Sciences, Western University, London, Ont. (Zomar, Marsh, Bryant); the Bone and Joint Institute, Western University, London, Ont. (Zomar, Marsh, Bryant, Lanting); the Division of Orthopaedic Surgery, London Health Sciences Centre, London, Ont. (Lanting); and the Schulich School of Medicine & Dentistry, Western University, London Ont. (Lanting).
London Health Sciences Centre · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne route to mitigate the increasing costs of total hip arthroplasty (THA) is outpatient THA, discharging patients on the same day as their surgery. The purpose of this study was to compare the cost of outpatient THA to standard overnight stay in hospital.

methodsThis was a preliminary analysis of the first group of patients to complete follow-up in a larger randomized controlled trial among patients who underwent primary THA through a direct anterior approach between June 2015 and November 2017. The study was conducted at a single centre among patients of 1 fellowship-trained arthroplasty surgeon. We randomly allocated participants to be discharged either as outpatients or on postsurgery day 1 using a modified Zelen consent model. Adverse events were recorded. Participants completed cost questionnaires 2, 6 and 12 weeks after surgery, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 12 weeks after surgery. We performed cost analyses from health care payer and societal perspectives.

resultsA total of 115 participants completed this study, 49 allocated to the outpatient group and 56 to the inpatient group. The adverse event rate was similar for the 2 groups. The WOMAC total score and function subscale score were higher for the outpatient group than the inpatient group at 12 weeks (mean difference 2.1, 95% confidence interval [CI] 0.0 to 4.1, and 6.5, 95% CI 0.4 to 12.5, respectively). From both a health care payer and a societal perspective, inpatient THA was more costly than outpatient THA (mean difference $1006.86, 95% CI -$2158.92 to $145.21, and $1667.40, 95% CI -$3856.64 to $521.84, respectively).

conclusionOur results suggest that outpatient THA may be a cost-saving procedure compared to inpatient THA from both health care payer and societal perspectives. Further study with larger samples is needed to provide more precision around our estimates.

trial registrationClinicalTrials.gov, no. NCT03026764.

Indexed as

Arthroplasty, Replacement, HipHospitalsHumansInpatientsOutpatientsPatient Discharge

Identifiers

PMID36302128
PMCPMC9451501
OpenAlexW4294026040

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.