Patient-reported measures have become essential tools to improve healthcare quality and ensure people‑centred care. Patient-reported outcome measures (PROMs) are often used as an indicator of the quality of care, including acute care such as hip and knee replacement surgery. They are used to monitor and promote delivery of patient-centred care as they provide information about patients’ perception of the quality of healthcare, such as whether the care they received met their individual goals and needs. Given the increasing importance of measuring PROMs to assess the quality of care in recent years, the number of people responding to PROMs requests in relation to hip and knee replacement surgery has increased across countries, even during the COVID‑19 pandemic when the volume of surgeries declined (OECD, forthcoming[1]).
Figure 6.27 shows changes between the pre‑operative and post-operative scores on the Oxford Hip Score (OHS) and Hip Disability and Osteoarthritis Outcome Score – Physical Short Form (HOOS-PS) scales reported by patients after elective hip replacement surgery for osteoarthritis, which are available in joint replacement registries across countries. Figure 6.28 shows changes between the pre‑operative and post-operative scores reported by patients using the Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score – Physical Short Form (KOOS-PS) after elective knee replacement surgery for osteoarthritis. Figure 6.29 shows quality of life of patients measured by the EuroQol 5‑Dimensional tool (EQ‑5D) before and after hip or knee replacement surgery.
In all countries, substantial improvements in PROMs scores were observed after operations. For example, average quality of life after hip surgery improved in all countries, reaching a score equivalent to 80% or higher, up from scores equivalent to 35‑50% pre‑surgery (based on the OHS). Average changes from pre‑operative to post-operative scores varied across countries in all scales. The highest change in OHS and OKS scores was observed in Ireland, where the improvement in quality of life measured by EQ‑5D was also highest. For HOOS-PS and KOOS-PS, the Netherlands had the highest change from before to after surgery.
It should be noted that variations in post-operative scores reflect not only cross-country differences in the quality of hip and knee replacement surgery but also other factors such as differences in socio-demographic and clinical characteristics of patients reporting PROMs, so caution is needed when interpreting variations across countries.
