IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0238287.html
   My bibliography  Save this article

Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis

Author

Listed:
  • Maria M Wertli
  • Judith M Schlapbach
  • Alan G Haynes
  • Claudia Scheuter
  • Sabrina N Jegerlehner
  • Radoslaw Panczak
  • Arnaud Chiolero
  • Nicolas Rodondi
  • Drahomir Aujesky

Abstract

Background: Compared to other OECD countries, Switzerland has the highest rates of hip (HA) and knee arthroplasty (KA). Objective: We assessed the regional variation in HA/KA rates and potential determinants of variation in Switzerland. Methods: We conducted a population-based analysis using discharge data from all Swiss hospitals during 2013–2016. We derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-/sex-standardized procedure rates and measures of variation (the extremal quotient [EQ, highest divided by lowest rate] and the systemic component of variation [SCV]). We estimated the reduction in variance of HA/KA rates across HSAs in multilevel regression models, with incremental adjustment for procedure year, age, sex, language, urbanization, socioeconomic factors, burden of disease, and the number of orthopedic surgeons. Results: Overall, 69,578 HA and 69,899 KA from 55 HSAs were analyzed. The mean age-/sex-standardized HA rate was 265 (range 179–342) and KA rate was 256 (range 186–378) per 100,000 persons and increased over time. The EQ was 1.9 for HA and 2.5 for KA. The SCV was 2.0 for HA and 2.2 for KA, indicating a low variation across HSAs. When adjusted for procedure year and demographic, cultural, and sociodemographic factors, the models explained 75% of the variance in HA and 63% in KA across Swiss HSAs. Conclusion: Switzerland has high HA/KA rates with a modest regional variation, suggesting that the threshold to perform HA/KA may be uniformly low across regions. One third of the variation remained unexplained and may, at least in part, represent differing physician beliefs and attitudes towards joint arthroplasty.

Suggested Citation

  • Maria M Wertli & Judith M Schlapbach & Alan G Haynes & Claudia Scheuter & Sabrina N Jegerlehner & Radoslaw Panczak & Arnaud Chiolero & Nicolas Rodondi & Drahomir Aujesky, 2020. "Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-18, September.
  • Handle: RePEc:plo:pone00:0238287
    DOI: 10.1371/journal.pone.0238287
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238287
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238287&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0238287?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Guccione, A.A. & Felson, D.T. & Anderson, J.J. & Anthony, J.M. & Zhang, Y. & Wilson, P.W.F. & Kelly-Hayes, M. & Wolf, P.A. & Kreger, B.E. & Kannel, W.B., 1994. "The effects of specific medical conditions on the functional limitations of elders in the Framingham study," American Journal of Public Health, American Public Health Association, vol. 84(3), pages 351-358.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Shemendyuk, Aleksandr & Wagner, Joël, 2024. "On the factors determining the health profiles and care needs of institutionalized elders," Insurance: Mathematics and Economics, Elsevier, vol. 114(C), pages 223-241.
    2. David R. Axon & Humza Ullah, 2023. "A Retrospective Database Study of Health Costs among United States Older Adults Who Documented Having Pain and Functional Impairment," Disabilities, MDPI, vol. 3(2), pages 1-10, April.
    3. Shih-Wei Huang & Yi-Wen Chen & Reuben Escorpizo & Chun-De Liao & Tsan-Hon Liou, 2021. "Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan," IJERPH, MDPI, vol. 18(4), pages 1-13, February.
    4. Ami Ogawa & Hirotaka Iijima & Masaki Takahashi, 2022. "Identification of Early Knee Osteoarthritis Based on Knee Joint Trajectory during Stair Climbing," IJERPH, MDPI, vol. 19(22), pages 1-11, November.
    5. Mary Beth Landrum & Kate A. Stewart & David M. Cutler, 2009. "Clinical Pathways to Disability," NBER Chapters, in: Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly, pages 151-187, National Bureau of Economic Research, Inc.
    6. Thierry Thomas & Françoise Amouroux & Patrice Vincent, 2017. "Intra articular hyaluronic acid in the management of knee osteoarthritis: Pharmaco-economic study from the perspective of the national health insurance system," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-17, March.
    7. Barbara Resnick, 1998. "Functional Performance of Older Adults in a Long-Term Care Setting," Clinical Nursing Research, , vol. 7(3), pages 230-246, August.
    8. Haas, Steven, 2008. "Trajectories of functional health: The 'long arm' of childhood health and socioeconomic factors," Social Science & Medicine, Elsevier, vol. 66(4), pages 849-861, February.
    9. Wilma Nusselder & Caspar Looman, 2004. "Decomposition of differences in health expectancy by cause," Demography, Springer;Population Association of America (PAA), vol. 41(2), pages 315-334, May.
    10. Parminder Raina & Steven Dukeshire & Joan Lindsay, 1997. "Prevalence, Risk Factors, and Primary Causes of Disability Among Canadian Seniors: An Analysis of the 1986 and 1991 Health and Activity Limitation Surveys," Independence and Economic Security of the Older Population Research Papers 11, McMaster University.
    11. Hyungsoo Kim & Jinkook Lee & Doh-Khul Kim, 2006. "The Impact of Age and Health on Vehicle Choices among Elders," Journal of Family and Economic Issues, Springer, vol. 27(3), pages 437-457, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0238287. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.