No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark
AimsThis study aimed to investigate the estimated change in primary and revision arthroplasty rate in the Netherlands and Denmark for hips, knees, and shoulders during the COVID-19 pandemic in 2020 (COVID-period). Additional points of focus included the comparison of patient characteristics and hosp...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2022-12-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/10.1302/2633-1462.312.BJO-2022-0111.R1 |
| _version_ | 1828089398890070016 |
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| author | Daisy Latijnhouwers Alma Pedersen Eskild Kristiansen Suzanne Cannegieter Berend W. Schreurs Wilbert van den Hout Rob Nelissen Maaike Gademan |
| author_facet | Daisy Latijnhouwers Alma Pedersen Eskild Kristiansen Suzanne Cannegieter Berend W. Schreurs Wilbert van den Hout Rob Nelissen Maaike Gademan |
| author_sort | Daisy Latijnhouwers |
| collection | DOAJ |
| description | AimsThis study aimed to investigate the estimated change in primary and revision arthroplasty rate in the Netherlands and Denmark for hips, knees, and shoulders during the COVID-19 pandemic in 2020 (COVID-period). Additional points of focus included the comparison of patient characteristics and hospital type (2019 vs COVID-period), and the estimated loss of quality-adjusted life years (QALYs) and impact on waiting lists.MethodsAll hip, knee, and shoulder arthroplasties (2014 to 2020) from the Dutch Arthroplasty Register, and hip and knee arthroplasties from the Danish Hip and Knee Arthroplasty Registries, were included. The expected number of arthroplasties per month in 2020 was estimated using Poisson regression, taking into account changes in age and sex distribution of the general Dutch/Danish population over time, calculating observed/expected (O/E) ratios. Country-specific proportions of patient characteristics and hospital type were calculated per indication category (osteoarthritis/other elective/acute). Waiting list outcomes including QALYs were estimated by modelling virtual waiting lists including 0%, 5% and 10% extra capacity.ResultsDuring COVID-period, fewer arthroplasties were performed than expected (Netherlands: 20%; Denmark: 5%), with the lowest O/E in April. In the Netherlands, more acute indications were prioritized, resulting in more American Society of Anesthesiologists grade III to IV patients receiving surgery. In both countries, no other patient prioritization was present. Relatively more arthroplasties were performed in private hospitals. There were no clinically relevant differences in revision arthroplasties between pre-COVID and COVID-period. Estimated total health loss depending on extra capacity ranged from: 19,800 to 29,400 QALYs (Netherlands): 1,700 to 2,400 QALYs (Denmark). With no extra capacity it will take > 30 years to deplete the waiting lists.ConclusionThe COVID-19 pandemic had an enormous negative effect on arthroplasty rates, but more in the Netherlands than Denmark. In the Netherlands, hip and shoulder patients with acute indications were prioritized. Private hospitals filled in part of the capacity gap. QALY loss due to postponed arthroplasty surgeries is considerable.Cite this article: Bone Jt Open 2022;3(12):977–990. |
| first_indexed | 2024-04-11T05:39:09Z |
| format | Article |
| id | doaj.art-6e52312e899b4f04886e147279b84bf3 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-04-11T05:39:09Z |
| publishDate | 2022-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-6e52312e899b4f04886e147279b84bf32022-12-22T09:52:01ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622022-12-0131297799010.1302/2633-1462.312.BJO-2022-0111.R1No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and DenmarkDaisy Latijnhouwers0Alma Pedersen1Eskild Kristiansen2Suzanne Cannegieter3Berend W. Schreurs4Wilbert van den Hout5Rob Nelissen6Maaike Gademan7Department of Orthopaedics, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsDutch Arthroplasty Register, Radboud University Medical Center, Nijmegen, the NetherlandsDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Orthopaedics, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Orthopaedics, Leiden University Medical Center, Leiden, the NetherlandsAimsThis study aimed to investigate the estimated change in primary and revision arthroplasty rate in the Netherlands and Denmark for hips, knees, and shoulders during the COVID-19 pandemic in 2020 (COVID-period). Additional points of focus included the comparison of patient characteristics and hospital type (2019 vs COVID-period), and the estimated loss of quality-adjusted life years (QALYs) and impact on waiting lists.MethodsAll hip, knee, and shoulder arthroplasties (2014 to 2020) from the Dutch Arthroplasty Register, and hip and knee arthroplasties from the Danish Hip and Knee Arthroplasty Registries, were included. The expected number of arthroplasties per month in 2020 was estimated using Poisson regression, taking into account changes in age and sex distribution of the general Dutch/Danish population over time, calculating observed/expected (O/E) ratios. Country-specific proportions of patient characteristics and hospital type were calculated per indication category (osteoarthritis/other elective/acute). Waiting list outcomes including QALYs were estimated by modelling virtual waiting lists including 0%, 5% and 10% extra capacity.ResultsDuring COVID-period, fewer arthroplasties were performed than expected (Netherlands: 20%; Denmark: 5%), with the lowest O/E in April. In the Netherlands, more acute indications were prioritized, resulting in more American Society of Anesthesiologists grade III to IV patients receiving surgery. In both countries, no other patient prioritization was present. Relatively more arthroplasties were performed in private hospitals. There were no clinically relevant differences in revision arthroplasties between pre-COVID and COVID-period. Estimated total health loss depending on extra capacity ranged from: 19,800 to 29,400 QALYs (Netherlands): 1,700 to 2,400 QALYs (Denmark). With no extra capacity it will take > 30 years to deplete the waiting lists.ConclusionThe COVID-19 pandemic had an enormous negative effect on arthroplasty rates, but more in the Netherlands than Denmark. In the Netherlands, hip and shoulder patients with acute indications were prioritized. Private hospitals filled in part of the capacity gap. QALY loss due to postponed arthroplasty surgeries is considerable.Cite this article: Bone Jt Open 2022;3(12):977–990.https://online.boneandjoint.org.uk/doi/10.1302/2633-1462.312.BJO-2022-0111.R1COVID-19 pandemicHipKneeShoulderArthroplastyQuality-adjusted life years |
| spellingShingle | Daisy Latijnhouwers Alma Pedersen Eskild Kristiansen Suzanne Cannegieter Berend W. Schreurs Wilbert van den Hout Rob Nelissen Maaike Gademan No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark Bone & Joint Open COVID-19 pandemic Hip Knee Shoulder Arthroplasty Quality-adjusted life years |
| title | No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark |
| title_full | No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark |
| title_fullStr | No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark |
| title_full_unstemmed | No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark |
| title_short | No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder arthroplasty surgeries in the Netherlands and Denmark |
| title_sort | no time to waste the impact of the covid 19 pandemic on hip knee and shoulder arthroplasty surgeries in the netherlands and denmark |
| topic | COVID-19 pandemic Hip Knee Shoulder Arthroplasty Quality-adjusted life years |
| url | https://online.boneandjoint.org.uk/doi/10.1302/2633-1462.312.BJO-2022-0111.R1 |
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