Trends in Orthopedic Surgery in Chile: Analysis Between 2004 and 2020

Abstract

To describe the trends of orthopedic surgery in Chile since 2004 in terms of the number and gender of surgeons, the incidence of procedures per 100,000 inhabitants (IR), and access by health insurance and type of health center. MethodsA cross-sectional study was designed. Three databases were analyzed: the free access database of the Chilean Department of Statistics and Health Information (DEIS), which had information on all procedures performed in health institutions in Chile from 2004 to 2020. Then, the orthopedic surgeon registry was requested from the National Superintendence of Health (NSH). Finally, the database of the Chilean Society of Orthopaedic Surgeons (SCHOT) was analyzed. Spearman's correlation was used to determine significant trends during the analyzed period. ResultsThe NSH reported 1770 orthopedic surgeons in 2020; 56% were affiliated with SCHOT. An upward trend in the proportion of female orthopedic surgeons was found, from 4.8% in 2004 to 7.6% in 2020. Since 2004, the IR of orthopaedic surgeries has been increasing significantly in both health insurances; the growth in public insurance follows a linear model (R 2 = 0.970) of parameters β 0 = -55982.6 (p <0.000) and β 1 = 28.02 (p <0.000) while in private insurance, the growth is also linear (R 2 = 0.890) but with a greater slope: β 0 = -104136 (p <0.000) and β 1 = 52.15 (p <0.000). A significant downward trend was found in the proportion of surgeries performed in the public health network (rho = -0.797, p = 0.0002). ConclusionsThere is a significant increase in the number of orthopedic surgeons and the number of procedures per 100,000 inhabitants. Nevertheless, there is evident inequity in access to orthopedic surgery in Chile and low gender diversity.

Impact of the COVID-19 Outbreak on Orthopedic Surgery: A Nationwide Analysis of the First Pandemic Year

“…The impact of them remains to be seen; however, according to the results of this research, a more significant number of postponed orthopedic procedures is expected. This only will broaden the gap of access to orthopedic surgery that already exists [6]. A prediction made in the UK in November 2020 suggests that if the level of productivity increased to 30%, it would take 20 to 46 months to return to the pre-COVID-19 waiting list number [34].…”

“…The same survey reported that the most frequent orthopedic procedures performed in Chile between 2004 and 2019 were: knee arthroscopy, rotator cuff repair, knee arthroplasty (KA) and hip arthroplasty (HA), knee ligament reconstruction, and hip, wrist, ankle, and open fractures. Those procedures accounted for 40% of the total orthopedic procedures [6].…”

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

“…Esto se explica por el alza de las listas de espera quirúrgica que alcanza los 290 mil procedimientos a marzo de 2021, con una espera promedio de 1,5 años [14]. 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].…”