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dc.contributor.authorHolsen, Maria
dc.contributor.authorHovind, Veronica
dc.contributor.authorBedane, Haji Kedir
dc.contributor.authorOsvoll, Knut Ivar
dc.contributor.authorGjertsen, Jan-Erik
dc.contributor.authorFurnes, Ove Nord
dc.contributor.authorWalsh, Mary E.
dc.contributor.authorIngebrigtsen, Tor
dc.date.accessioned2022-11-23T09:17:48Z
dc.date.available2022-11-23T09:17:48Z
dc.date.issued2022-09-14
dc.description.abstractBackground: Standardized surgery rates for common orthopedic procedures vary across geographical areas in Norway. We explored whether area-level factors related to demand and supply in publicly funded healthcare are associated with geographical variation in surgery rates for six common orthopedic procedures.<p> <p>Methods: The present study is a cross-sectional population-based study of hospital referral areas in Norway. We included adult admissions for arthroscopy for degenerative knee disease, arthroplasty for osteoarthritis of the knee and hip, surgical treatment for hip fracture, and decompression with/ without fusion for lumbar disk herniation and lumbar spinal stenosis in 2012–2016. Variation in age and sex standardized rates was estimated using extremal quotients, coefficients of variation, and systematic components of variation (SCV). Associations between surgery rates and the socioeconomic factors urbanity, unemployment, low-income, high level of education, mortality, and number of surgeons and hospitals were explored with linear regression analyses. <p>Results: Knee arthroscopy showed highest level of variation (SCV 10.3) and decreased in numbers. Variation was considerable for spine surgery (SCV 3.8–4.9), moderate to low for arthroplasty procedures (SCV 0.8–2.6), and small for hip fracture surgery (SCV 0.2). Higher rates of knee arthroscopy were associated with more orthopedic surgeons (adjusted coefficient 24.8, 95% confidence interval (CI): 2.7–47.0), and less urban population (adjusted coefficient −13.3, 95% CI: −25.4 to −1.2). Higher spine surgery rates were associated with more hospitals (adjusted coefficient 22.4, 95% CI: 4.6–40.2), more urban population (adjusted coefficient 2.1, 95% CI: 0.4–3.8), and lower mortality (adjusted coefficient −192.6, 95% CI: −384.2 to −1.1). Rates for arthroplasty and hip fracture surgery were not associated with supply/demand factors included. <p>Conclusions: Arthroscopy for degenerative knee disease decreased in line with guidelines, but showed high variation of surgery rates. Socioeconomic factors included in this study did not explain geographical variation in orthopedic surgery.en_US
dc.identifier.citationHolsen M, Hovind V, Bedane HK, et al. Geographical variation in orthopedic procedures in Norway: Cross-sectional population-based study. Scandinavian Journal of Surgery. 2022;111(4):92-98.en_US
dc.identifier.cristinIDFRIDAID 2065400
dc.identifier.doi10.1177/14574969221118488
dc.identifier.issn1457-4969
dc.identifier.issn1799-7267
dc.identifier.urihttps://hdl.handle.net/10037/27493
dc.language.isoengen_US
dc.publisherSAGEen_US
dc.relation.journalScandinavian Journal of Surgery
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleGeographical variation in orthopedic procedures in Norway: Cross-sectional population-based studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
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