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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
W.J. Millar, MA, MSc, Health Statistics Division, Statistics Canada, 18th Floor, R. H. Coats Building, Tunney's Pasture, Ottawa, ON K1A 0T6, Canada, (613)951-1631, millway@statcan.ca
Data Sources: Data were obtained from hospital morbidity files maintained by Statistics Canada for 1981/82 to 1998/99. In 1998/99 a linked hospital file was used to examine readmission rates of index cases of knee or hip replacement surgery. The three leading diagnoses and three leading surgical procedures were reviewed for patients who were readmitted to hospital within 30 days after knee or hip replacement surgery. Supplementary data relating to risk factors for knee and hip surgery were obtained from the 1998/99 National Population Health Survey.
Analytical techniques: Hospitalisation rates were calculated by dividing the number of surgery separations of the population aged 65 or older by the population estimates for the age/sex group and dividing by 100,000. Confidence intervals were calculated to assess the variation in rates between 1981/82 and 1998/99 for each province. Cross-tabulations relating to the prevalence of overweight and arthritis were obtained from the National Population Health Survey. Bootstrap procedures were used to estimate exact variances and to test differences between provincial and national level estimates.
Results: Since 1981/82 there has been a growth in surgical rates for both knee and hip replacement surgery. Among persons aged 65 and older, hip replacement surgery increased from 164.5 per 100,000 in 1981/82 to 335.3 per 100,000 in 1998/99. The corresponding rates for knee replacement surgery were 45.9 in 1981/82 and 389.9 in 1998/99. Knee replacement rates now exceed hip replacement rates. Women have higher rates for both hip and knee replacement surgery. The proportion of knee and hip replacement surgery that involves persons aged 75 and older has increased from about 25% in 1981/82 to about 33% in 1998/99. In 1981/82 a patient aged 65 or older could anticipate a hospital stay of about 27 days for a hip or knee replacement. By 1998/99 the length of stay had been reduced to about 11.4 days for hip replacement and 9.1 days for knee replacement surgery. Surgical rates vary considerably by province and do not appear to be associated with the prevalence of overweight and arthritis in the provincial populations. About 32% of hip replacement patients and 28% of knee replacement patients are re-admitted to hospital within thirty days for follow-up surgical procedures or complications from the surgery. Among hip replacement patients, the mortality rate is 1.6%. The corresponding mortality rate for knee replacement patients is 0.6%.
Learning Objectives:
Keywords: Health Care Delivery, Aging
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.