Richard E Guerrero-Ludueña1, Mercè Comas2, Mireia Espallargues3, Moisès Coll4, Miquel Pons5, Santiago Sabatés6, Alejandro Allepuz7, Xavier Castells8. 1. Epidemiology and Evaluation Department, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 2. Epidemiology and Evaluation Department, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Health Services Research on Chronic Patients Network (Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC]), Barcelona, Spain. Electronic address: mcomas@parcdesalutmar.cat. 3. Health Services Research on Chronic Patients Network (Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC]), Barcelona, Spain; Agency for Health Quality and Assessment of Catalonia (Agència de Qualitat i Avaluació Sanitàries de Catalunya [AQuAS]), Barcelona, Spain. 4. Traumatology and Orthopaedic Surgery Department, Hospital de Mataró, Mataró, Spain. 5. Traumatology and Orthopaedic Surgery Department, Hospital de Sant Rafael, Barcelona, Spain. 6. Traumatology and Orthopaedic Surgery Department, Hospital Mútua de Terrassa, Terrassa, Spain. 7. Agency for Health Quality and Assessment of Catalonia (Agència de Qualitat i Avaluació Sanitàries de Catalunya [AQuAS]), Barcelona, Spain. 8. Epidemiology and Evaluation Department, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Health Services Research on Chronic Patients Network (Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC]), Barcelona, Spain.
Abstract
OBJECTIVES: To estimate future utilization scenarios for knee arthroplasty (KA) revision in the Spanish National Health System in the short- and long-term and their impact on primary KA utilization. METHODS: A discrete-event simulation model was built to represent KA utilization for 20 years (2012-2031) in the Spanish National Health System. Data on KA utilization from 1997 to 2011 were obtained from the minimum data set. Three scenarios of future utilization of primary KA (1, fixed number since 2011; 2, fixed age- and sex-adjusted rates since 2011; and 3, projection using a linear regression model) were combined with two prosthesis survival functions (W [worse survival], from a study including primary KA from 1995 to 2000; and B [better survival], from the Catalan Registry of Arthroplasty, including primary KA from 2005 to 2013). The simulation results were analyzed in the short-term (2015) and the long-term (2030). RESULTS: Variations in the number of revisions depended on both the primary utilization rate and the survival function applied, ranging from increases of 8.3% to 31.6% in the short- term and from 38.3% to 176.9% in the long-term, corresponding to scenarios 1-B and 3-W, respectively. The prediction of increases in overall surgeries ranged from 0.1% to 22.3% in the short-term and from 3.7% to 98.2% in the long-term. CONCLUSIONS: Projections of the burden of KA provide a quantitative basis for future policy decisions on the concentration of high-complexity procedures, the number of orthopedic surgeons required to perform these procedures, and the resources needed.
OBJECTIVES: To estimate future utilization scenarios for knee arthroplasty (KA) revision in the Spanish National Health System in the short- and long-term and their impact on primary KA utilization. METHODS: A discrete-event simulation model was built to represent KA utilization for 20 years (2012-2031) in the Spanish National Health System. Data on KA utilization from 1997 to 2011 were obtained from the minimum data set. Three scenarios of future utilization of primary KA (1, fixed number since 2011; 2, fixed age- and sex-adjusted rates since 2011; and 3, projection using a linear regression model) were combined with two prosthesis survival functions (W [worse survival], from a study including primary KA from 1995 to 2000; and B [better survival], from the Catalan Registry of Arthroplasty, including primary KA from 2005 to 2013). The simulation results were analyzed in the short-term (2015) and the long-term (2030). RESULTS: Variations in the number of revisions depended on both the primary utilization rate and the survival function applied, ranging from increases of 8.3% to 31.6% in the short- term and from 38.3% to 176.9% in the long-term, corresponding to scenarios 1-B and 3-W, respectively. The prediction of increases in overall surgeries ranged from 0.1% to 22.3% in the short-term and from 3.7% to 98.2% in the long-term. CONCLUSIONS: Projections of the burden of KA provide a quantitative basis for future policy decisions on the concentration of high-complexity procedures, the number of orthopedic surgeons required to perform these procedures, and the resources needed.
Authors: Juliette A Meyer; Mark Zhu; Alana Cavadino; Brendan Coleman; Jacob T Munro; Simon W Young Journal: Arch Orthop Trauma Surg Date: 2021-01-30 Impact factor: 3.067
Authors: Alexander Upfill-Brown; Peter P Hsiue; Troy Sekimura; Brendan Shi; Seth A Ahlquist; Jay N Patel; Micah Adamson; Alexandra I Stavrakis Journal: Arthroplast Today Date: 2022-05-21
Authors: Manuel Weißenberger; Alexander Klug; Yves Gramlich; Maximilian Rudert; Philipp Drees; Reinhard Hoffmann; Karl Philipp Kutzner Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-07-15 Impact factor: 4.342