Trends in Knee and Hip Arthroplasty in Chile Between 2004 and 2019

Barahona, Maximiliano; Barrientos, Cristián; Escobar, Francisco; Díaz, N.; Palma, Daniel González; Barahona, Macarena A; Martínez, Alexis; Infante, C.

doi:10.7759/cureus.12185

Cited by 7 publications

(11 citation statements)

References 21 publications

(24 reference statements)

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“…Dentro de esta lista, la artroplastia es la segunda cirugía con más pacientes en espera y con una espera mayor que este promedio, superando los dos años [15]. En lista de espera para artroplastia de rodilla en 2019 se encontraban 15 mil pacientes y en el mismo año, se realizaron 2963 en instituciones públicas, es decir en espera hay cinco veces la cantidad de prótesis que se implantan en un año [9]. La pandemia por COVID-19 tuvo un impacto negativo importante en la realización de esta cirugía [10], y de acuerdo a datos obtenidos por Ley de Transparencia a junio de 2022 la lista de espera en artroplastia de rodilla es de 20 316 pacientes.…”

Section: Investigaciónunclassified

“…Si bien Chile tiene una población más joven que los demás países pertenecientes a la OCDE, y por lo tanto menos pacientes en riesgo, sí es cierto que el acceso determina un rol importante. En Chile, los pacientes beneficiarios de seguro privado (aproximadamente 18% de la población) acceden a este procedimiento 2,5 veces más que los pacientes pertenecientes al seguro público, denominado Fondo Nacional de Salud (FONASA) [9].…”

Section: Introductionunclassified

“…Si bien los pacientes beneficiarios del Fondo Nacional de Salud han tenido un alza en el acceso a artroplastia de rodilla entre 2004 y 2019, aún existe una brecha [9]. Al revisar la lista de espera en el sistema nacional de salud, se observa que hasta 2019 la artroplastia de rodilla ocupaba el segundo lugar tras la colecistectomía, con una mediana de espera de 2,2 años desde que el paciente fue visto en la atención terciaria [9]. Esto probablemente no cambió durante la pandemia, dado que hubo una disminución por sobre el 50% en la incidencia de esta cirugía en 2020 [10].…”

Section: Introductionunclassified

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Access to knee arthroplasty among National Health Fund beneficiaries in Chile between 2004 and 2021

Barahona¹,

Cárcamo²,

Barahona³

et al. 2023

Medwave

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Introduction Knee osteoarthritis affects the quality of life, with knee arthroplasty being a cost-effective treatment for the severe stage of this disease. Access to knee arthroplasty is a health indicator of the Organisation for Economic Co-operation and Development. The objectives of this study are to determine the incidence of knee arthroplasty between 2004 and 2021 in beneficiaries of the National Health Fund in Chile, the proportion of patients who underwent surgery in the private system, and to estimate the patient's out-of-pocket expenditure for surgery. Methods Cross-sectional study. We used the Department of Statistics and Health Information database. Patients discharged from a Chilean health center who underwent knee arthroplasty surgery between 2004 and 2021 were investigated. We analyzed the proportion of patients by their National Health Fund category and whether their surgery was performed in public or private network facilities. Results Of the 31 526 knee arthroplasty procedures, 21 248 (67.38%) were performed on National Health Fund patients and 16 238 in public institutions (51.49%). Patients from the National Health Fund showed a systematic increase in knee arthroplasty volume until 2019 but decreased in 2020 and 2021 by 68% and 51%. Of the total number of patients in the public system operated on for knee arthroplasty, 856 (9%) belonged to group A1, 12 806 (60%) to group B, 2044 (10%) to group C, and 4421 (21%) to group D. The expenditure incurred by these patients was estimated to vary between 24.4% and 27.2%. The historical proportions of access to this surgery in private institutions are 7% in group A, 13% in group B, 24% in group C, and 52% in group D. Conclusion Fifty percent of knee arthroplasty surgeries are performed in public institutions, and two-thirds are performed on patients of the National Health Fund. Forty-six percent of the C and D groups were operated in the private system. The pandemic has increased the access gap, leading to a substantial increase in the proportion of patients from the National Health Fund of the B, C, and D groups who have migrated to the private system to access this surgery.

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Section: Investigaciónunclassified

Section: Introductionunclassified

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Access to knee arthroplasty among National Health Fund beneficiaries in Chile between 2004 and 2021

Barahona¹,

Cárcamo²,

Barahona³

et al. 2023

Medwave

View full text Add to dashboard Cite

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“…El mismo reporte informa un promedio de espera de 558 días, es decir 1,5 años [3]. La patología más frecuente en espera corresponde a colecistectomía, seguida por artroplastia de rodilla, con una mediana de espera de 2,5 años [4].…”

Section: Introductionunclassified

Efficiency estimation on the use of elective surgical theaters in the Chilean public health system from 2018 to 2021

Barahona¹,

Cárcamo²,

Barrientos³

et al. 2023

Medwave

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Objective The efficient use of wards intended for elective surgeries is essential to resolve cases on the surgical waiting list. This study aims to estimate the efficiency of ward use in the Chilean public health system between 2018 and 2021. Methods The design was an ecological study. Section A.21 of the database constructed by the monthly statistical summaries that each public health network facility reported to the Ministry of Health between 2018 and 2021 was analyzed. Data from subsections A, E and F were extracted: ward staffing, total elective surgeries by specialty, number and causes of suspension of elective surgeries. Then, the surgical performance during working hours and the percentage of hourly occupancy for a working day was estimated. Additionally, an analysis was made by region with data from 2021. Results The percentage of elective wards in use ranged from 81.1% to 94.1%, while those enabled for those staffing ranged from 70.5% to 90.4% during 2018 and 2021. The total number of surgeries was highest in 2019 (n = 416 339), but for 2018, 2020, and 2021 it ranged from 259 000 to 297 000. Suspensions varied between 10.8% (2019) and 6.9% (2021), with the leading cause being patient-related. When analyzing the number of cases canceled monthly by facility, we saw that the leading cause was trade union-related. The maximum throughput of a ward intended for elective surgery was reached in 2019 and was 2.5 surgeries; in 2018, 2020 and 2021, the throughput borders on two surgeries per ward enabled for elective surgery. The percentage of ward time occupied during working hours by contract day varies between 80.7% (2018) and 56.8% (2020). Conclusions All the parameters found and estimated in this study show that there is an inefficient utilization of operating rooms in Chilean public healthcare facilities.

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“…La tasa de osteoartritis (OA) después de una lesión meniscal o de LCA depende de varios factores, tales como: el trauma, características específicas de la técnica quirúrgica, el tipo de rehabilitación, el regreso a las actividades deportivas, inestabilidad crónica y lesiones posteriores asociadas, particularidades del paciente antes de la cirugía, como el nivel de actividad física, la fuerza muscular, el índice de masa corporal, personalidad y educación (4) . Identificar estas características es objetivo de un registro nacional, lo cual nuestro país carece en la actualidad, limitando la posibilidad de establecer políticas públicas en relación con estas patologías (7) .…”

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Tendencias en procedimientos meniscales y reconstrucción de ligamentos de rodilla en Chile: estudio transversal entre 2004-2019

et al. 2023

Rev. Hosp. Clín. Univ. Chile (En línea)

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Purpose: The aim of this study was to describe the incidence rate per 100,000 inhabitants (IR) of knee arthroscopic procedures and knee ligament reconstruction in Chile, between 2004 and 2019. Methods: Cross-sectional study. Patients who underwent a meniscal surgery and patients undergoing knee ligament reconstruction were identified in the database of the Chilean department of statistics and health information (DEIS) between 2004 and 2019. Results: The DEIS reported 149,734 patients, 169244 arthroscopic procedures with a significant upward trend in the IR, from 24.61 in 2004 to 80.6 in 2019. Related to knee ligament reconstruction, 42,026 procedures were found in 38,171 patients, with a significant upward trend in the IR, from 4.08 in 2004 to 24.62 in 2019. Conclusions: Knee arthroscopy and ligament reconstruction are in an upward trend in Chile. An evident inequity in access was found public insurance needs to improve the quality and access to both procedures. An updated, national registry is urgently needed to improve data, allowing better health policies.

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Trends in Knee and Hip Arthroplasty in Chile Between 2004 and 2019

Cited by 7 publications

References 21 publications

Access to knee arthroplasty among National Health Fund beneficiaries in Chile between 2004 and 2021

Access to knee arthroplasty among National Health Fund beneficiaries in Chile between 2004 and 2021

Efficiency estimation on the use of elective surgical theaters in the Chilean public health system from 2018 to 2021

Tendencias en procedimientos meniscales y reconstrucción de ligamentos de rodilla en Chile: estudio transversal entre 2004-2019

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