Evidence map›Paper›PMID 39726407›Full record

ArticleArthritis care & research2025

Estimating Budget Impact and Joint Replacement Avoidance by Implementing a Standardized Education and Exercise Therapy Program for Hip and Knee Osteoarthritis in a Publicly Insured Health Care System.

Darren R Mazzei, Jackie L Whittaker, Peter Faris, Tracy Wasylak, Deborah A Marshall

Abstract read
In one paragraph

Article in Arthritis care & research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
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

5 authors.

Darren R MazzeiUniversity of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada.
Jackie L WhittakerUniversity of Calgary, Calgary, Alberta, and Arthritis Research Canada and the University of British Columbia, Vancouver, British Columbia, Canada.ORCID 0000-0002-6591-4976
Peter FarisUniversity of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
Tracy WasylakUniversity of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
Deborah A MarshallUniversity of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada.ORCID 0000-0002-8467-8008

Funding

Alberta Health Services Bone and Joint Health Strategic Clinical NetworkArthritis Society Training Graduate PhD Salary Award TGP-119-0476Arthur JE Child Chair Rheumatology Outcomes ResearchCanada Research Chair in Health Systems and Services ResearchCanadian Institute for Health Research (CIHR) HI8-177447Cumming School of Medicine Graduate Student Scholarship
6 · The paper itself

Abstract

objectiveThe study objective was to estimate the budget impact of funding a standardized education and exercise therapy program, Good Life with osteoArthritis in Denmark (GLA:D) for people with hip and knee osteoarthritis (OA) waiting for total joint replacement (TJR) consultation in a universal publicly insured health care system in Canada.

methodsWe built a budget impact analysis model to estimate the annual cost (Canadian dollars) of providing the GLA:D program to people waiting for a TJR consultation and then forecasted a three-year budget cycle. The base case assumes that 40% attend GLA:D sessions, that 11% avoid surgery, uniform care delivery, that training costs are incurred separately, and that the health care system has enough trained staff to meet demand. The population of people with hip and knee OA waiting for a TJR consultation was estimated with government statistics, peer-reviewed evidence, and routinely collected data from five orthopedic centralized intake clinics (serving 80% of people seeking TJR). Patient-level costs were collected prospectively. International published evidence informed the TJR avoidance estimates. A one-way sensitivity analysis of key parameters evaluated model robustness. Four scenarios were analyzed: public funding for everyone (base case), low-income, rural, and uninsured persons.

resultsFunding GLA:D would cost $4.3 million, serve 12,500 people, and save $8.5 million by avoiding 1,300 TJRs in year one. Savings grow to $8.8 and $8.7 million in years two and three. The number of TJRs performed annually produced the most uncertainty in budget impact (-$15.3 million, -$1.8 million). The most cautious parameter estimates still produce cost savings.

conclusionPublicly funding standardized education and exercise therapy programs for everyone waiting for a TJR consultation would avoid surgeries, improve access to evidence-based treatments, and save more than the program costs.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeBudgetsExercise TherapyNational Health ProgramsOsteoarthritis, HipOsteoarthritis, KneePatient Education as TopicAgedCost-Benefit AnalysisCost SavingsDenmarkFemaleHealth Care CostsHumansMale

Identifiers

PMID39726407
PMCPMC12121330

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.