Osteoarthritis, or OA, is a degenerative disease affecting the hands, hips and knees. It is the most common form of arthritis, often leading to knee and hip replacement surgery.
Researchers have found that a proven hospital-based program, called the Osteoarthritis Hip and Knee Service (OAHKS), also has the potential to deliver efficient community-based care to people living with the disease.
“OAHKS has been embedded in Victorian public hospitals since 2006,” explains physiotherapist, Alison Gibbs. “The service relies on the expertise of advanced musculoskeletal physiotherapists assessing and triaging patients with hip and knee osteoarthritis, so that orthopaedic surgeons can prioritise their time with patients most likely to require surgical intervention.”
In a new study published in Musculoskeletal Science & Practice, Gibbs and collaborators compared the first Victorian community-based OAHKS site, located within an independent health centre, with a hospital-based counterpart. The community-based OAHKS had access to orthopaedic referrals, if required. The study examined measures including patient and practitioner satisfaction, referral rates for surgical opinion and waiting times.
While the patient experience was positive for both cohorts, waiting times and referral rates to orthopaedics at community-based OAHKS were substantially lower. “Satisfaction was comparable but slightly higher in the community health setting,” adds Gibbs.
“Some patients have to travel long distances to access OAHKS care,” says Gibbs, “and so a community-based model may offer considerable benefit. Fewer people were referred to the surgeons from the community OAHKS, which may reduce the rate of joint replacement.”
The study’s community-based OAHKS service was established through a Department of Health and Human Services grant and has received ongoing funding. The research team are now planning to work with local GPs to increase the number of referrals.
“We want to make it easier for people to access OAHKS and exercise-based programs,” adds Gibbs. “We also hope to reduce the waiting time for those patients who do need to see a surgeons and, ultimately, reduce the number of people requiring joint replacements.”