A controlled before-after study to evaluate the effect of a clinician led policy to reduce knee arthroscopy in NSW

BMC Musculoskeletal Disorders
H Y ChenJ-F Levesque

Abstract

Clinical evidence shows knee arthroscopy has little benefit for degenerative conditions and considerable variation in the incidence of knee arthroscopy in Australia has been identified. This study aimed to evaluate a clinician-led evidence-based policy which was implemented in one local health district in New South Wales (NSW) in 2012 to reduce the use of knee arthroscopy for patients aged 50 years or over. Trends in rates and volume of knee arthroscopy for patients 50 years or over in NSW between 2004 and 2015 by district were examined. Changes at four hospitals that adopted the policy were assessed by a quasi-experimental before and after study design with control groups, using the generalised estimating equations (GEE) Poisson model. Each case hospital was matched with four control hospitals in terms of the volume of knee arthroscopy surgeries performed in the five years prior to the intervention. Between 2004 and 2015, the number of knee arthroscopies in NSW initially increased and then decreased after 2011, with considerable variation across districts. While an overall reducing trend in NSW was observed between 2011 and 2015 (39%), a 58% reduction (95% CI: 55-62%) was found in the intervention district, including the priva...Continue Reading

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Citations

Aug 8, 2018·BMJ Quality & Safety·Tim Badgery-ParkerAdam G Elshaug
Nov 15, 2019·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Ali KiadaliriMartin Englund
Jan 8, 2020·BMJ Quality & Safety·Richard N de Steiger
May 31, 2019·BMC Health Services Research·Tim Badgery-ParkerAdam G Elshaug
Mar 26, 2021·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Sonia R Grover, Karen Joseph
Jul 26, 2019·Osteoarthritis and Cartilage·L S Lohmander, T L N Järvinen

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