A Comparative Study of Health-Related Quality-of-Life Outcomes in Patients Undergoing Total Hip Arthroplasty in the Hungarian Public and Private Healthcare

OBJECTIVES: The study aimed to compare the health-related quality-of-life outcomes of total hip arthroplasty patients in public and private healthcare in Hungary.

METHODS: Patients were selected at the Department of Orthopedics, Clinical Centre of the University of Pécs and at the Da Vinci Private Clinic in Pécs (Hungary). In the selected public hospital, surgery is mainly performed with a traditional anterolateral approach, while in the private hospital it is performed with a minimally invasive technique and anterior approach. Patients completed the SF-36 and Oxford Hip Score (OHS) questionnaires before the surgery and 3 months later.

RESULTS: The research involved 232 patients, 123 patients in public healthcare (45 male, 78 female, mean age: 67.24), 109 patients in private healthcare (52 male, 57 female, mean age: 63.77). The SF-36 Physical Health score (PCS) increased from 27.70 to 57.16 points for public hospitals patients and from 35.42 to 74.98 points for patients in the private hospital (p<0.001) by the 3^rd month after surgery. The SF-36 Mental Health score (MCS) increased from 69.31 to 77.54 for public healthcare patients (p=0.001) and from 67.50 to 84.56 for private patients (p<0.001). The Oxford Hip Score showed an increase from 16.49 to 34.57 points for public patients and from 21.76 to 39.94 points for private patients (p<0.001). There was no difference in the improvement in OHS scores between the two healthcare sectors (p=0.949), but private patients showed greater improvement in SF-36 scores (PCS: p=0.001, MCS: p=0.007).

CONCLUSIONS: When comparing quality-of-life scores, both healthcare sectors showed significant improvement at the 3^rd month after total hip arthroplasty, but regarding the SF-36 questionnaire, the improvement was greater for private patients.