Impact of a national guideline on use of knee arthroscopy : An interrupted time-series analysis
Kiadaliri, Ali LU
; Bergkvist, Dan
LU
; Dahlberg, Leif E
LU
and Englund, Martin
LU
(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
-
- pmid:31725873
- scopus:85082147936
- 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
- 2024-06-12 04:40:38
@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}},
}