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Physiotherapy after arthroscopic partial meniscectomy surgery: An assessment of costs to the National Health Service, patients, and society

Published online by Cambridge University Press:  25 October 2005

Peter Charles Goodwin
Affiliation:
Manchester Metropolitan University
Julie Ratcliffe
Affiliation:
University of Sheffield
Matthew Charles Morrissey
Affiliation:
King's College London

Abstract

Objectives: The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery.

Methods: The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis.

Results: Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS.

Conclusions: Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

Type
GENERAL ESSAYS
Copyright
© 2005 Cambridge University Press

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References

Ashby J, Buxton M, Gravelle H. 1989. What costs do women meet for early detection and diagnosis of breast problems? HERG Research Report No. 6. London: Health Economics Research Group, Brunel University;
Dandy DJ, O'Carroll PF. 1982 Arthroscopic surgery of the knee. Br Med J (Clin Res Ed). 285: 12561258. In: Allum R. 2002 Complications of arthroscopy of the knee. J Bone Joint Surg Br. 84: 937945.Google Scholar
Department of Health. Hospital episode statistics England: Financial year 2001–02. London: HMSO.
Department of Health. 2002. National schedule of reference costs: NHS trust outpatient HRG data, Appendix 1E, Trauma & orthopaedics: Non-trauma HRG label. London: HMSO;
Department of Transport. 1989. Values of time and vehicle operating costs for 1989. COBA 9 manual, Annex II, Section 8.2, 8.3-8.10. London: Department of Transport;
Dobson C. 1995 Record audit: A study of the quality and effectiveness of the treatment of knee conditions. Physiotherapy. 81: 217221.Google Scholar
Donaldson C, Hundley V, McIntosh E. 1996 Using economics alongside clinical trials: Why we cannot choose the evaluation technique in advance. Letter. Health Econ. 5: 267269. In: Briggs AH, O'Brien BJ. 2001 The death of cost-minimisation analysis? Health Econ. 10: 179184.Google Scholar
Drummond MF, Jefferson TO. 1996 Guidelines for authors and peer reviewers of economic submissions to the BMJ. BMJ Economic Evaluation Working Party. BMJ. 313: 275283.Google Scholar
Drummond MF, O'Brien B, Stoddart GL, Torrance GW. 1997. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford: Oxford University Press;
Forster DP, Frost CEB. 1982 Cost-effectiveness study of outpatient physiotherapy after medial meniscectomy. Br Med J (Clin Res Ed). 284: 485487.Google Scholar
Goodwin P, Morrissey MC, Omar RZ, et al. 2003 Effectiveness of supervised physical therapy in the early period after knee partial meniscectomy surgery. Phys Ther. 83: 520535.Google Scholar
Jensen JE, Conn RR, Hazelrigg G, Hewett JE. 1985 The use of transcutaneous neural stimulation and isokinetic testing in arthroscopic knee surgery. Am J Sports Ther. 13: 2733.Google Scholar
Jokl P, Stull PA, Lynch JK, Vaughan V. 1989 Independent home versus supervised rehabilitation following arthroscopic knee surgery—a prospective randomized trial. Arthroscopy. 5: 298305.Google Scholar
Kernick D. 2000 Costs are as important as outcomes. BMJ. 321: 567.Google Scholar
Kernick D, Reinhold D, Netten A. 2000 What does it cost to see the doctor? Br J Gen Pract. 50: 401403.Google Scholar
Netten A, Curtis L. Unit costs of health and social care. Personal Social Services Research Unit, University of Kent. Available at: www.ukc.ac.uk/PSSRU. Accessed 2002.
Office for National Statistics (ONS). Available at: www. statistics.gov.uk. Accessed 2002.
Officer LH. 2004. What is its relative value in UK pounds? Economic History Services, Available at: www.eh.net/hmit/ukcompare/. Accessed October 30
Rockborn P, Hamberg P, Gillquist J. 2000 Arthroscopic meniscectomy. Treatment costs and postoperative function in a historical perspective. Acta Orthop Scand. 71: 455460.Google Scholar
Ross MJ, Berger RS. 1996 Effects of stress inoculation training on athletes' postsurgical pain and rehabilitation after orthopaedic injury. J Consult Clin Psychol. 64: 406410.Google Scholar
Sergeant T, Edwards A. 1979 Alternative post-meniscectomy regimen. BMJ. 1: 449450.Google Scholar
Seymour N. 1969 The effectiveness of physiotherapy after medial meniscectomy. Br J Surg. 56: 518520.Google Scholar
The Automobile Association. The insiders guide to driving a car. Available at: www.theaa/allaboutcars. Accessed 2003.
Williams RA, Morrissey MC, Brewster CE. The effect of electrical stimulation on quadriceps strength and thigh circumference in meniscectomy patients. J Orthop Sports Phys Ther. 1985; 8: 143146.CrossRefGoogle Scholar