Determining the need for hip and knee arthroplasty: The role of clinical severity and patients' preferences
Determining the need for hip and knee arthroplasty: The role of clinical severity and patients' preferences
复制标题
DOI：
10.1097/00005650-200103000-00002
复制
发表时间：
2001-03-01
期刊：
影响因子：
3
通讯作者：
Badley, EM
中科院分区：
文献类型：
--
作者：
Hawker, GA;Wright, JG;Badley, EM
背景在使用外科干预（如关节成形术）时，区域变化被认为是令人担忧的和不适当的。为了确定区域关节成形术率是否反映了患者相关的需求因素，我们估计了在加拿大安大略的高使用率和低使用率区域进行关节成形术的需求和意愿。基于人口的邮件和电话调查。所有年龄大于或等于55岁的成年人在高（n = 21，925）和低（n = 26，293）关节置换术使用区域。我们通过问卷调查确定关节炎的严重程度和合并症，通过检查和X线片确定关节炎的存在，并通过访谈评估关节置换的意愿。潜在的关节成形术需求被定义为严重关节炎，没有绝对的手术禁忌症，以及检查和X线片显示关节炎的证据。然后根据患者接受关节成形术的意愿调整需求估计。问卷和访谈的回复率为72.0%。高比率地区的潜在关节置换需求为36.3/1000，而低比率地区为28.5/1000（P
BACKGROUND. Area variation in the use of surgical interventions such as arthroplasty is viewed as concerning and inappropriate.OBJECTIVES. To determine whether area arthroplasty rates reflect patient-related demand factors, we estimated the need for and the willingness to undergo arthroplasty in a high and a low-use area of Ontario, Canada.RESEARCH DESIGN. Population-based mail and telephone survey.SUBJECTS. All adults aged greater than or equal to 55 years in a high (n = 21,925) and low (n = 26,293) arthroplasty use area.MEASURES. We determined arthritis severity and comorbidity with questionnaires, established the presence of arthritis with examination and radiographs, and evaluated willingness to have arthroplasty with interviews. Potential arthroplasty need was defined as severe arthritis, no absolute contraindication for surgery, and evidence of arthritis on examination and radiographs, Estimates of need were then adjusted for patients' willingness to undergo arthroplasty.RESULTS. Response rates were 72.0% for questionnaires and interviews. The potential need for arthroplasty was 36.3/1,000 respondents in the high-rate area compared with 28.5/1,000 in the low-rate area (P