Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis

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Impact of a national guideline on use of knee arthroscopy : An interrupted time-series analysis. / Kiadaliri, Ali; Bergkvist, Dan; Dahlberg, Leif E; Englund, Martin.

I: International Journal for Quality in Health Care, Vol. 31, Nr. 9, 2019, s. G113–G118.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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TY - JOUR

T1 - Impact of a national guideline on use of knee arthroscopy

T2 - An interrupted time-series analysis

AU - Kiadaliri, Ali

AU - Bergkvist, Dan

AU - Dahlberg, Leif E

AU - Englund, Martin

N1 - © 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.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

U2 - 10.1093/intqhc/mzz089

DO - 10.1093/intqhc/mzz089

M3 - Article

C2 - 31725873

VL - 31

SP - G113–G118

JO - International Journal for Quality in Health Care

JF - International Journal for Quality in Health Care

SN - 1464-3677

IS - 9

ER -