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Trends in Knee and Hip Arthroplasty in Chile Between 2004 and 2019
Maximiliano Barahona1, Cristian Barrientos1, Francisco Escobar1
1Orthopaedic Department, Hospital Clinico Universidad De Chile, Santiago, CHL.
Insights
Hip and knee arthroplasty incidence in Chile increased significantly from 2004-2019. Access to these procedures shows inequity, with private insurance patients receiving more surgeries than public insurance patients.
Area of Science:
- Orthopedics
- Public Health
- Health Economics
Background:
- Arthroplasty, including hip arthroplasty (HA) and knee arthroplasty (KA), is a common procedure for treating joint degeneration.
- Understanding the incidence and trends of arthroplasty is crucial for healthcare planning and resource allocation.
Purpose of the Study:
- To determine the incidence rate of arthroplasty in Chile between 2004 and 2019.
- To analyze trends in hip and knee arthroplasty over the study period.
- To identify disparities in arthroplasty access based on insurance type and age.
Main Methods:
- Cross-sectional study utilizing the Chilean Department of Statistics and Health Information (DEIS) database.
- Inclusion of all hospital discharges for arthroplasty procedures from 2004 to 2019.
- Analysis of trends using Spearman's correlation.
Main Results:
- A total of 133,518 arthroplasties were performed, with hip arthroplasty (73.35%) being more frequent than knee arthroplasty (23.92%).
- Significant upward trends were observed for both HA (rho=0.95, p<0.000) and KA (rho=0.98, p<0.000).
- Patients with private insurance aged over 60 had 1.8 times more HA and 2.5 times more KA than similarly aged public insurance patients. 20% of public insurance patients received arthroplasty in private centers.
Conclusions:
- Hip arthroplasty is more common than knee arthroplasty in Chile.
- Chile exhibits a lower arthroplasty incidence compared to OECD countries, attributed to a younger population and health access inequities.
- Recommendations include expanding coverage and establishing a national arthroplasty registry in Chilean health policies.
Abstract:
Introduction The purpose of this study is to describe the incidence rate (IR) per 100,000 inhabitants of arthroplasty in Chile between 2004 and 2019, emphasizing knee and hip arthroplasty. Methods This is a cross-sectional study. Patients who underwent arthroplasty between 2004 and 2019 were identified in the free access database of the Chilean Department of Statistics and Health Information (DEIS), which depends directly on the Ministry of Health. This register stores all hospital discharges of the country from private or public health centers. The trend during the period of study was analyzed using Spearman's correlation. Results From a total of 111,303 patients, 133,518 arthroplasties were performed. Hip arthroplasty (HA) accounted for 73.35%, followed by knee arthroplasty (KA) (23,92%). A significant upward trend was found in HA (rho=0.95, p<0.000) and KA (rho=0.98, p<0.000). Most of the surgeries were done within the Public Health Network (61,6%), but 20% of patients affiliated with public insurance underwent arthroplasty in a private center. Patients above 60 years of age affiliated with private insurance underwent 1.8 HA and 2.5 KA for every one HA and KA undergone by patients of the same age group who were affiliated with public insurance. Conclusion HA was more frequent than KA. A significant gap was found in the incidence of arthroplasty as compared to countries belonging to the Organization for Cooperation and Economic Development, given by a less aged population and by inequity in health access. Wider coverage and a national registry for arthroplasty must be considered in Chilean health policies.
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