caa a22 4500 606180451 CHVBK 20210128100806.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s11136-014-0782-9 doi (NATIONALLICENCE)springer-10.1007/s11136-014-0782-9 Comparison of pre- and post-operative health-related quality of life and length of stay after primary total hip replacement in matched English and German patient cohorts [Elektronische Daten] [Matthias Vogl, Reiner Leidl, Werner Plötz, Nils Gutacker] Purpose: We compare pre- and post-operative health-related quality of life (HRQoL) and length of stay after total hip replacement (THR) in matched German and English patient cohorts to test for differences in admission thresholds, clinical effectiveness and resource utilisation between the healthcare systems. Methods: German data (n=271) were collected in a large orthopaedic hospital in Munich, Germany; English data (n=26,254) were collected as part of the national patient-reported outcome measures programme. HRQoL was measured using the EuroQoL-5D instrument. Propensity score matching was used to construct two patient cohorts that are comparable in terms of preoperative patient characteristics. Results: Before matching, patients in England showed lower preoperative EQ-5D scores (0.35 vs 0.52, p<0.001) and experienced a larger improvement in HRQoL (0.43 vs 0.33, p<0.001) than German patients. Patients in the German cohort were more likely to report no or only moderate problems with mobility and pain preoperatively than their English counterparts. After matching, improvements in HRQoL were comparable (0.32 vs 0.33, p=0.638); post-operative scores were slightly higher in the German cohort (0.82 vs 0.85, p=0.585). Length of stay was substantially lower in England than in Germany (4.5 vs 9.0days, p<0.001). Conclusions: Our results highlight differences in preoperative health status between countries, which may arise due to different admission thresholds and access to surgery. In terms of quality of life, THR surgery is equally effective in both countries when performed on similar patients, but hospital stay is shorter in England. Springer International Publishing Switzerland, 2014 Health-related quality of life nationallicence EQ-5D nationallicence Total hip replacement nationallicence England nationallicence Germany nationallicence Vogl Matthias Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München, German Research Center for Environmental Health, P.O. Box 1129, 85758, Neuherberg, Munich, Germany aut Leidl Reiner Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München, German Research Center for Environmental Health, P.O. Box 1129, 85758, Neuherberg, Munich, Germany aut Plötz Werner Department of Orthopaedics and Trauma Surgery, Krankenhaus Barmherzige Brüder München, Romanstraße 93, 80639, Munich, Germany aut Gutacker Nils Centre for Health Economics, University of York, YO10 5DD, Heslington, York, UK aut Quality of Life Research Springer International Publishing 24/2(2015-02-01), 513-520 0962-9343 24:2<513 2015 24 11136 https://doi.org/10.1007/s11136-014-0782-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-014-0782-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vogl Matthias Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München, German Research Center for Environmental Health, P.O. Box 1129, 85758, Neuherberg, Munich, Germany aut NATIONALLICENCE 700 1- Leidl Reiner Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München, German Research Center for Environmental Health, P.O. Box 1129, 85758, Neuherberg, Munich, Germany aut NATIONALLICENCE 700 1- Plötz Werner Department of Orthopaedics and Trauma Surgery, Krankenhaus Barmherzige Brüder München, Romanstraße 93, 80639, Munich, Germany aut NATIONALLICENCE 700 1- Gutacker Nils Centre for Health Economics, University of York, YO10 5DD, Heslington, York, UK aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/2(2015-02-01), 513-520 0962-9343 24:2<513 2015 24 11136