gms | German Medical Science

Background and status of (inter)national research: The German and Dutch health care systems differ substantially in their postoperative treatment of patients after total hip arthroplasty (THA). Where most German patients receive an extensive postoperative rehabilitation program, Dutch patients are usually send home within 3–4 days postoperative receiving no or only a limited amount of physiotherapeutic aftercare. Previous research however, suggests that the more extensive German approach does not automatically result in greater satisfaction and better patient reported outcomes (PRO)[1]. Current literature indicates an influence of preoperative expectations and self-efficacy on postoperative THA outcome [2]. Preoperative expectations in turn are possibly influenced by patient and health care characteristics and thus might differ between both countries.

Question and objective: The question is to what extend the postoperative satisfaction and PROs are influenced by preoperative expectations, and in addition, what role patient and health care characteristics play. Hence, the aim of this study therefore is to compare preoperative expectations and postoperative satisfaction as well as PRO between German vs. Dutch THA patients.

Method: A comparative study with two natural cohorts will be conducted. A prospective sample of150 Dutch and 150 German THA patients will be surveyed over the course of treatment and rehabilitation (T0 – prior to surgery, T1 – 3 months after surgery, T2 – 6 months after surgery). Patients and providers will be recruited through the University Hospital for Orthopedics and Trauma Surgery, Campus Pius-Hospital in Oldenburg, the University Medical Center Groningen and affiliated regional hospitals (i.e. Ommelander Ziekenhuis Groningen (OZG) in Scheemda and Klinikum Leer). Preoperative expectations and self-efficacy will be measured with the HSS Expectation survey and SER respectively. Postoperative satisfaction will be measured with a one-item questionnaire and health related quality of life with the HOOS and SF36. The intergrated model of Laferton et al. [3] on patient expectations will be used to conceptualize the association of the outcomes.

Discussion: By means of this study, knowledge will be gained with respect to the influence of health care and patient characteristics on preoperative expectations and postoperative THA outcome. Based on these insights, treatment protocols could potentially be improved.