There Is No Difference in Outpatient Costs Within One Year Post-Total Hip Arthroplasty when Comparing Surgical Approach
Bibliographic record
Abstract
BACKGROUND: Total hip arthroplasty (THA) continues to be a substantial financial burden to the Canadian health care system. The purpose of this study was to determine the impact of surgical approach on the associated outpatient cost of THA. METHODS: Patients who underwent a THA via an anterior, posterior, or lateral approach were recruited (not randomized). All patients prospectively completed a cost diary (self-reported use of allied health services, investigations, clinic visits, patient expenses, and number of employment days lost to THA) to estimate total resource use and patient expenses incurred after discharge. Group comparisons were performed using Pearson's Chi-squares and one-way analyses of variance; significance was accepted at P ≤ 0.05. RESULTS: A prospective, microcosting analysis was performed on 104 patients undergoing a THA through either an anterior (n = 37), posterior (n = 32), or lateral (n = 35) approach for one year postoperatively. The overall costs of outpatient resources and expenses were comparable between anterior ($1,321.00 CDN), posterior ($1,094.92 CDN), and lateral ($1,153.18 CDN) approaches (P = 0.114). When the overall costs were stratified by specific expenses, the costs of allied health services were significantly higher in the anterior group ($361.32 CDN; 95% confidence interval, 257.58 to 465.07) than the posterior group ($206.50 CDN; 95% confidence interval, 124.50 to 288.50, P = 0.028). This correlated with a higher number of average nursing care visits for the anterior group than both the posterior and lateral groups (P = 0.001). There were no differences in costs of clinic visits, investigations, or number of employment days lost to THA. CONCLUSIONS: Cost analysis on the effect of surgical approach for THA in outpatient resources and expenses resulted in comparable overall costs between the anterior, posterior, and lateral approaches. Future directions include capturing long-term effectiveness measures to perform a cost-effectiveness analysis from a societal perspective.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".