Establishing the important quality of life indicators when measuring the impact of waiting for orthopaedic care: A Preliminary Study

Ms Joanne Morris1, Associate Professor Steve Milanese1, Associate Professor Lorraine Sheppard1, Dr Diana Perriman2, Ms Christen Richardson3

1University Of South Australia, Adelaide, Australia, 2Canberra Health Services, Canberra, Australia, 3Australian National University, Canberra, Australia

Background: Increased demand on public orthopaedic outpatient services can result in lengthy wait times, potentially effecting an individual’s quality of life (QoL) and costs.

Study aim: To identify how waiting to be seen by an orthopaedic surgeon impacts patients with a range of musculoskeletal conditions in terms of QoL and cost indicators.

Methods:  Participants included patients waiting for outpatient orthopaedic services at the Canberra Hospital. Nineteen participants were interviewed for this study. The length of waiting on the waiting list ranged from 1 month to 3 years (mean 14.56 months). A card sort methodology was used to explore QoL and cost factors that may be impacted in these participants whilst waiting an initial consultation. Exploratory factor analysis was used to identify the key QoL and cost factors reported and these were described using emergent themes.

Results:  QoL and cost statements described as severely effecting QoL and cost factors were mapped to nine themes in descending order of impact; pain, economic stress, walking difficulties, loss of independence, decreased functional ability, loss of social role and psychological distress, change in function associated with more acute presentations, limitations due to back and lower limb problems, and the necessity for paid carer assistance.

Conclusions:  Musculoskeletal conditions have a severe impact on QoL and costs which are exacerbated by prolonged waiting. The domains of pain, economic hardship, functional loss and social and psychological distress were marked.  This preliminary data will inform a larger study aimed at developing an assessment tool for this cohort.


Joanne Morris graduated with a BSc (Hons) Physiotherapy from the University Birmingham (UK) in 1999. She worked in the UK in a variety of settings for 5 years, during which time she completed a Masters in Clinical Biomechanics at the University of Salford. Since 2004 Joanne has worked Australia with a particular interest in musculoskeletal physiotherapy.  Joanne worked for 8 years as an extended scope physiotherapist in Orthopaedics and the Emergency Department.  In recent times Joanne has held various leadership roles at Canberra Health Services and is currently Executive Director of Allied Health and acting Executive Director of Rehabilitation Aged and Community Care.

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