Geographical variation in the provision of elective primary hip and knee replacement: the role of socio-demographic, hospital and distance variables

Judge, Andrew; Welton, Nicky J; Sandhu, Jeet; Ben-Shlomo, Yoav

doi:10.1093/pubmed/fdp061

Cited by 61 publications

(58 citation statements)

References 29 publications

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“…Similar variations were reported for THR ranging from 2.3 to 5.8. Such geographic variation in TJR rates has been also reported in other countries such as Australia [33], the United Kingdom [34], Finland [35], and Germany [36]. These differences, which often remain even after adjusting for age [36], have been attributed to various factors, including a lack of consensus regarding the indications for these procedures [24,32].…”

Section: Discussionmentioning

confidence: 85%

Propensity score matching and randomization

Mnatzaganian

Davidson

Hiller

et al. 2015

Journal of Clinical Epidemiology

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Section: Discussionmentioning

confidence: 85%

Propensity score matching and randomization

Mnatzaganian

Davidson

Hiller

et al. 2015

Journal of Clinical Epidemiology

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“…However, rates of knee replacement per head of population, adjusted for age and sex, vary enormously. For example, a recent study from the UK reported geographical variation across different regions in England, 9 and similar data has been uncovered within Sweden, through its arthroplasty registry 10 . Further analysis of data in England, Sweden, Canada and other countries indicate that inequities exist, with those who are most socio‐economically deprived being the least likely to be operated upon 9–13 .…”

Section: Variations and Inequities In The Provision Of Kjrsmentioning

confidence: 76%

Who should have knee joint replacement surgery for osteoarthritis?

Dieppe¹,

Lim

Lohmander³

2011

Int J of Rheum Dis

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Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10-20% of people who have this surgery are unhappy with the outcome, and have persistent pain. In this article we briefly discuss the variations in utilization of knee joint replacement, and then outline four different approaches to the selection and prioritisation of patients for this procedure. Consensus criteria, including appropriateness criteria are available, but if produced by professionals alone, they may conflict with the views of patients and the public. Databases and cohort studies can be used to attempt relating outcomes to baseline characteristics, but at present we can only account for a small percentage of the variance with this technique. Finally, we propose use of the 'capacity to benefit framework' to attempt providing guidance to both patients and healthcare professionals.

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“…In recent decades, limited access to healthcare services has been a problem in many countries (Pomey et al, ). In addition, considerable variations in geographic and sociodemographic factors (Judge, Welton, Sanhu, & Ben‐Shlomo, ; Neuburger, Hutchings, Allwood, Black, & van der Meulen, ) and indications for surgery (Dreinhofer et al, ; McBride et al, ) have been observed. Our study found out that the eHealth solution could be used to monitor referral status in real time.…”

Section: Discussionmentioning

confidence: 99%

Healthcare professionals’ proposed eHealth needs in elective primary fast‐track hip and knee arthroplasty journey: A qualitative interview study

Jansson

Harjumaa

Puhto

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To examine the lived experience of healthcare professionals providing care for patients with total hip and knee arthroplasty and to understand healthcare professionals’ proposed eHealth needs in elective primary fast‐track hip and knee arthroplasty journey. Background There is little evidence in nursing literature to indicate how to develop new eHealth services to support surgical care journeys. Evidence is particularly lacking regarding the development of eHealth solutions. Design This was a qualitative interview study. Methods Semi‐structured interviews were conducted with four surgeons, two anaesthesiologists, ten nurses and four physiotherapists in a single joint replacement centre during autumn 2018. The data were analysed using an inductive content analysis method. NVivo qualitative data analysis software was used. The COREQ checklist for qualitative studies was followed. Results Our research addressed the gap in evidence by focusing on the four main parts of the patient journey in the selected context. Analysis of the data revealed nine main categories for the proposed eHealth needs: eligibility criteria, referrals, meeting the Health Care Guarantee, patient flow, postdischarge care, patient counselling, communication, transparency of the journey and receiving feedback. In addition, the requirements and further development needs for eHealth solutions were generally identified. Conclusions From the point of view of healthcare professionals, eHealth solutions have huge potential in supporting the elective primary fast‐track hip and knee arthroplasty journey. However, it is important to acknowledge that these needs may be very different depending on the technological and organisational environment in question. Relevance to clinical practice More effective use of information and communication technologies is needed for organisational optimisation resulting in a streamlined pathway, better access to healthcare services, improved outcomes and an improved patient experience. These results can be used in the development of new eHealth solutions to support surgical care journeys and patient education.

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Geographical variation in the provision of elective primary hip and knee replacement: the role of socio-demographic, hospital and distance variables

Cited by 61 publications

References 29 publications

Propensity score matching and randomization

Propensity score matching and randomization

Who should have knee joint replacement surgery for osteoarthritis?

Healthcare professionals’ proposed eHealth needs in elective primary fast‐track hip and knee arthroplasty journey: A qualitative interview study

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