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Geographic variation and factors associated with rates of knee arthroplasty in Korea-a population based ecological study

Cited 4 time in Web of Science Cited 4 time in Scopus
Authors
Kim, Agnus M.; Kang, Sungchan; Park, Jong Heon; Yoon, Tae Ho; Kim, Yoon
Issue Date
2019-09-02
Publisher
BioMed Central
Citation
BMC Musculoskeletal Disorders, 20(1):400
Keywords
Knee arthroplastyKnee replacementRepublic of KoreaBedsUtilization
Abstract
Background
The recent increase in knee arthroplasty (KA) use in Korea is among the highest in the world. The rapid increase in KA use suggests that the KA use in Korea could have been affected by medically unjustifiable factors. This study aimed to examine the geographic variation in the rate of KA and its associated factors in Korea.

Methods
We used the data from the National Health Insurance in Korea in 2013, from which a total of 67,086 claims for KA were obtained. We calculated the age-sex-standardized KA rates of the entire population and the crude rates of the age groups 0–64 and 65 and over in 251 districts. We assessed the geographic variation of the KA rates and examined the associated factors with a multivariate linear regression with the KA rate as a dependent variable.

Results
The overall rate of KA in Korea was 132.7 per 100,000 persons. The rates of KA showed a four-fold variation. The deprivation index score and the number of beds in the small to medium sized hospitals showed a positive association with the rates of KA while the number of orthopedic surgeons showed a negative association.

Conclusions
Korea has been experiencing a rapid increase in the use of KA for the last decade or so, which was most prominent among the elderly population aged 65 and older. Our results suggest that the higher rate of KA is strongly related to a higher supply of beds and the socioeconomically deprived conditions. Considering that the decision concerning KA has room for discretion and also affects a considerable portion of health care expenditures, the use of KA should be thoroughly monitored with more emphasis on standardization in the decision making process and preventive measures that can lessen the need for KA.
ISSN
1471-2474
Language
English
URI
http://hdl.handle.net/10371/162637
DOI
https://doi.org/10.1186/s12891-019-2766-y
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College of Medicine/School of Medicine (의과대학/대학원)Health Policy and Management (의료관리학전공)Journal Papers (저널논문_의료관리학전공)
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