Grant: Project Grant

Osteoarthritis (OA) is a chronic disease affecting 10-15% of Canada's population. It causes severe pain and disability, and is the leading cause of joint replacement surgery. Healthcare service planning does not currently consider patient preferences and its impact on health interventions. This could lead to the introduction of programs that patients do not use, which is a waste of system resources. The explicit consideration of evidence from patient-preferences in assessing uptake of health services and the impact on wait times, patient outcomes and costs is essential to inform the design of effective patient-centered health services delivery. In previous work by our team, we built a simulation model that captures OA patient flows, healthcare resource use and costs. We will measure individual patient preferences, and incorporate these into the simulation model. Then, we will use it evaluate how patient outcomes and system performance will be altered when new health interventions are implemented, taking into account how many patients would choose those interventions. We will look at two different policies aimed at addressing wait times for surgery. The first is a referral management policy which would give patients information about wait times for different surgeons, and allows them to choose their preferred surgeon or the surgeon with the shortest wait time. The second policy offers patients the choice of an evidence-based conservative medical management program. Our study will look at whether patients would take up this alternative program and how this varies by characteristics of the program such as its cost. Depending on patient choices, both policies may shorten overall wait times, improve outcomes and reduce costs. Our team of OA clinicians, decision makers, researchers, patients and analysts has the expertise and engagement to ensure our research is clinically meaningful and is translated into patient-centred policy and practice.