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Could a disruptive out patient healthcare delivery model reduce escalating in-hospital healthcare costs in knee osteoarthritis
  1. Arockia Doss
  1. Correspondence to Dr Arockia Doss, Image Guided Therapy Clinic, Suite 3, 55 Hampden Road, Nedlands, WA 6009, Australia; rocki.doss{at}


Background Healthcare costs from in-hospital joint surgery for degenerative joint diseases are predicted to significantly increase to potentially unsustainable levels in the next several decades.

Aim As an index model, this paper presents cost-effectiveness predictions for an innovative combination treatment of image-guided percutaneous autologous blood-derived growth factors and exercises (IPGFE) for painful knee osteoarthritis managed in an out of hospital interventional radiology (IR) clinic through a disruptive healthcare delivery model.

Materials and methods Non-randomised retrospective case registry data were analysed. Patients suitable for TKR who underwent IPGFE were included. Knee function outcome scores were converted to quality of life years (QALY) gained. Median percentage improvement after IPGFE in knee function was converted to cost per QALYs by input of direct costs.

Results Median cost per QALY for IPGFE was AU$ 208.33 for 7.2 QALY gained. In comparison, the median cost per QALY for TKR was AU$2739 for 4.5 QALY gained. Incremental cost-effectiveness ratio for IPGFE was AU$4827.77 not spent per QALY gained in comparison to TKR.

Conclusions An out of hospital care model may be a less expensive option to gain better quality of life in comparison to knee joint replacement surgery for some patients. Out of hospital IR techniques should be studied further for their efficacy and potential to offer considerable healthcare cost savings in comparison to joint replacement surgery.

  • Osteoarthritis
  • Orthopaedics
  • Imaging

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