To determine the relationship between regional variations in knee replacement (KR) utilization rates in Ontario, Canada, and the reported prevalence of arthritis and rheumatism as a chronic health problem.
Utilization data were acquired from the Canadian Institute for Health Information for KR procedures performed in Ontario between fiscal years 1984 and 1990.
Census information was obtained from Statistics Canada.
Disease prevalence data were derived from the 1990 Ontario Health Survey (OHS).
Public Health Units (PHU) were used as the unit of analysis. with utilization rates defined as the number of KR performed on all PHU residents (irrespective of where these procedures were performed) divided by the population.
Direct methods were used to standardize utilization for age, sex, and disease prevalence.
The extremal quotient, the weighted coefficient of variation, and the systematic component of variation were used as measures of variation.
The relationship between the number of KR performed in each age-sex-year strata and various demographic (age and sex). disease prevalence, and regional dummy variables was estimated using a Poisson regression model.
Regional variation in the standardized utilization of KR surgery was wide, but declined over the study period ; the extremal quotient fell from 8.0 to 3.3, the weighted coefficient of variation fell from 0.49 to 0.30, and the systematic component of variation fell from 0.20 to 0.17. (...)
Mots-clés Pascal : Epidémiologie, Prévalence, Rhumatisme inflammatoire, Polyarthrite rhumatoïde, Homme, Canada, Amérique du Nord, Amérique, Arthrose, Analyse corrélation, Traitement, Prothèse, Genou, Chronique, Membre inférieur, Système ostéoarticulaire pathologie, Immunopathologie, Maladie autoimmune, Arthropathie, Maladie dégénérative, Chirurgie orthopédique
Mots-clés Pascal anglais : Epidemiology, Prevalence, Inflammatory joint disease, Rheumatoid arthritis, Human, Canada, North America, America, Osteoarthritis, Correlation analysis, Treatment, Prosthesis, Knee, Chronic, Lower limb, Diseases of the osteoarticular system, Immunopathology, Autoimmune disease, Arthropathy, Degenerative disease, Orthopedic surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0048289
Code Inist : 002B30A01A2. Création : 14/05/1998.