Quality Adjusted Life Years gained in patients aged over 65 years after total hip replacement.

Background: Total hip replacement (THR) is an effective, but also cost-intensive health care procedure for the elderly. Because of demographic changes in Western Europe, THR-associated financial investment for health care has become a question of priorities in society. To provide a quantitative rationale for a discussion within Western European health care systems, we undertook a prospective assessment of the benefit of THR from the patients´ perspective and as measured by quality-adjusted life years (QALYs).
Aim: To measure the difference in health related quality of life between an intervention and control group preoperatively and at follow-up 9 months after THR.
Methods: A randomised clinical trial allocating 180 patients aged over 65 years to either an intervention group or a control group. The control group received conventional treatment and the intervention group received both conventional treatment and telephone intervention. QALYs were calculated from measures of health-related quality of life using questionnaire SF-36. These scores were transformed to QALYs using a formula based on the method developed by Brazier (Brazier 1998).
Results: Both the control and the intervention patients reported significant changes in quality adjusted life years from preoperative status to 3 and 9 months after surgery. Patients in the interventions group had a significantly higher raise in qualy from baseline to 3 months after surgery.
Interpretation: There was a significant gain in QALYs in both groups. However, no significant or clinically relevant differences between the two groups were observed at follow-up within this timeframe.