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Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study

BACKGROUND: The recent increase in knee arthroplasty (KA) use in Korea is among the highest in the world. The rapid increase in KA use suggests that the KA use in Korea could have been affected by medically unjustifiable factors. This study aimed to examine the geographic variation in the rate of KA...

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Autores principales: Kim, Agnus M., Kang, Sungchan, Park, Jong Heon, Yoon, Tae Ho, Kim, Yoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721190/
https://www.ncbi.nlm.nih.gov/pubmed/31477060
http://dx.doi.org/10.1186/s12891-019-2766-y
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author Kim, Agnus M.
Kang, Sungchan
Park, Jong Heon
Yoon, Tae Ho
Kim, Yoon
author_facet Kim, Agnus M.
Kang, Sungchan
Park, Jong Heon
Yoon, Tae Ho
Kim, Yoon
author_sort Kim, Agnus M.
collection PubMed
description BACKGROUND: The recent increase in knee arthroplasty (KA) use in Korea is among the highest in the world. The rapid increase in KA use suggests that the KA use in Korea could have been affected by medically unjustifiable factors. This study aimed to examine the geographic variation in the rate of KA and its associated factors in Korea. METHODS: We used the data from the National Health Insurance in Korea in 2013, from which a total of 67,086 claims for KA were obtained. We calculated the age-sex-standardized KA rates of the entire population and the crude rates of the age groups 0–64 and 65 and over in 251 districts. We assessed the geographic variation of the KA rates and examined the associated factors with a multivariate linear regression with the KA rate as a dependent variable. RESULTS: The overall rate of KA in Korea was 132.7 per 100,000 persons. The rates of KA showed a four-fold variation. The deprivation index score and the number of beds in the small to medium sized hospitals showed a positive association with the rates of KA while the number of orthopedic surgeons showed a negative association. CONCLUSIONS: Korea has been experiencing a rapid increase in the use of KA for the last decade or so, which was most prominent among the elderly population aged 65 and older. Our results suggest that the higher rate of KA is strongly related to a higher supply of beds and the socioeconomically deprived conditions. Considering that the decision concerning KA has room for discretion and also affects a considerable portion of health care expenditures, the use of KA should be thoroughly monitored with more emphasis on standardization in the decision making process and preventive measures that can lessen the need for KA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2766-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-67211902019-09-10 Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study Kim, Agnus M. Kang, Sungchan Park, Jong Heon Yoon, Tae Ho Kim, Yoon BMC Musculoskelet Disord Research Article BACKGROUND: The recent increase in knee arthroplasty (KA) use in Korea is among the highest in the world. The rapid increase in KA use suggests that the KA use in Korea could have been affected by medically unjustifiable factors. This study aimed to examine the geographic variation in the rate of KA and its associated factors in Korea. METHODS: We used the data from the National Health Insurance in Korea in 2013, from which a total of 67,086 claims for KA were obtained. We calculated the age-sex-standardized KA rates of the entire population and the crude rates of the age groups 0–64 and 65 and over in 251 districts. We assessed the geographic variation of the KA rates and examined the associated factors with a multivariate linear regression with the KA rate as a dependent variable. RESULTS: The overall rate of KA in Korea was 132.7 per 100,000 persons. The rates of KA showed a four-fold variation. The deprivation index score and the number of beds in the small to medium sized hospitals showed a positive association with the rates of KA while the number of orthopedic surgeons showed a negative association. CONCLUSIONS: Korea has been experiencing a rapid increase in the use of KA for the last decade or so, which was most prominent among the elderly population aged 65 and older. Our results suggest that the higher rate of KA is strongly related to a higher supply of beds and the socioeconomically deprived conditions. Considering that the decision concerning KA has room for discretion and also affects a considerable portion of health care expenditures, the use of KA should be thoroughly monitored with more emphasis on standardization in the decision making process and preventive measures that can lessen the need for KA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2766-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-02 /pmc/articles/PMC6721190/ /pubmed/31477060 http://dx.doi.org/10.1186/s12891-019-2766-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kim, Agnus M.
Kang, Sungchan
Park, Jong Heon
Yoon, Tae Ho
Kim, Yoon
Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title_full Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title_fullStr Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title_full_unstemmed Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title_short Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study
title_sort geographic variation and factors associated with rates of knee arthroplasty in korea-a population based ecological study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721190/
https://www.ncbi.nlm.nih.gov/pubmed/31477060
http://dx.doi.org/10.1186/s12891-019-2766-y
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