Impact of a national guideline on use of knee arthroscopy : An interrupted time-series analysis
(2019) In International Journal for Quality in Health Care 31(9). p.113-118- Abstract
OBJECTIVE: To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA).
DESIGN: Interrupted time series analysis.
SETTING: Public health care in Skåne region.
PARTICIPANTS: Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015.
INTERVENTION(S): National guideline's recommendation against the use of knee arthroscopy in patients with knee OA.
MAIN OUTCOME MEASURE(S): 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne... (More)
OBJECTIVE: To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA).
DESIGN: Interrupted time series analysis.
SETTING: Public health care in Skåne region.
PARTICIPANTS: Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015.
INTERVENTION(S): National guideline's recommendation against the use of knee arthroscopy in patients with knee OA.
MAIN OUTCOME MEASURE(S): 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ≥40 years.
RESULTS: A total of 6,155 knee arthroscopy were performed among people aged ≥40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6% (95% CI: 9.3, 47.8) and 34.7% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period.
CONCLUSION: The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.
(Less)
- author
- Kiadaliri, Ali LU ; Bergkvist, Dan LU ; Dahlberg, Leif E LU and Englund, Martin LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- in
- International Journal for Quality in Health Care
- volume
- 31
- issue
- 9
- pages
- 113 - 118
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85082147936
- pmid:31725873
- ISSN
- 1464-3677
- DOI
- 10.1093/intqhc/mzz089
- project
- Quasi-experimental study design
- language
- English
- LU publication?
- yes
- additional info
- © The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
- id
- 78cf1586-d539-49e8-8cdd-21c96ff05c1f
- date added to LUP
- 2019-11-15 13:30:32
- date last changed
- 2024-08-21 11:11:14
@article{78cf1586-d539-49e8-8cdd-21c96ff05c1f, abstract = {{<p>OBJECTIVE: To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA).</p><p>DESIGN: Interrupted time series analysis.</p><p>SETTING: Public health care in Skåne region.</p><p>PARTICIPANTS: Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015.</p><p>INTERVENTION(S): National guideline's recommendation against the use of knee arthroscopy in patients with knee OA.</p><p>MAIN OUTCOME MEASURE(S): 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ≥40 years.</p><p>RESULTS: A total of 6,155 knee arthroscopy were performed among people aged ≥40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6% (95% CI: 9.3, 47.8) and 34.7% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period.</p><p>CONCLUSION: The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.</p>}}, author = {{Kiadaliri, Ali and Bergkvist, Dan and Dahlberg, Leif E and Englund, Martin}}, issn = {{1464-3677}}, language = {{eng}}, number = {{9}}, pages = {{113--118}}, publisher = {{Oxford University Press}}, series = {{International Journal for Quality in Health Care}}, title = {{Impact of a national guideline on use of knee arthroscopy : An interrupted time-series analysis}}, url = {{http://dx.doi.org/10.1093/intqhc/mzz089}}, doi = {{10.1093/intqhc/mzz089}}, volume = {{31}}, year = {{2019}}, }