Format

Send to

Choose Destination
Z Orthop Unfall. 2018 Oct 26. doi: 10.1055/a-0648-4945. [Epub ahead of print]

[Hip Osteoarthritis - Epidemiology and Current Medical Care Situation - Health Care Data of 2.4 Million AOK Baden-Württemberg Insurees Aged 40 Years or Older].

[Article in German; Abstract available in German from the publisher]

Author information

1
Patientensicherheit und Arzneimittel, aQua-Institut Göttingen, Deutschland.
2
Fachbereich Versorgungs-Controlling und Analytik, AOK Baden-Württemberg Hauptverwaltung, Stuttgart, Deutschland.
3
Ärztlicher Direktor Orthopädisch-Unfallchirurgisches Zentrum, UMM Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland.
4
Abteilungsleitung, Patientensicherheit und Arzneimittel, aQua-Institut, Göttingen, Deutschland.
5
Fachbereich Integriertes Leistungsmanagement, AOK Baden-Württemberg Hauptverwaltung, Stuttgart, Deutschland.
6
Vorsitzender des Vorstandes, AOK Baden-Württemberg Hauptverwaltung, Stuttgart, Deutschland.
7
Berufsverband für Orthopädie und Unfallchirurgie e.V. (BVOU), Berlin, Deutschland.
8
Orthopädische Gemeinschaftspraxis, Ortho-Zentrum, Karlsruhe, Deutschland.

Abstract

in English, German

BACKGROUND:

Due to demographic changes an increasing number of hip osteoarthritis can be expected with corresponding effects on the health care system. Hence, the objectives of our study were to obtain substantiated evidence about current medical care situation of hip osteoarthritis patients including outpatient care situation and hip replacement surgery.

PATIENTS AND METHODS:

Overall, the medical care data of 2.4 million insurees of the AOK Baden-Württemberg for the years 2007 to 2016 were analyzed. Lower limit of age was 40 years. The data includes outpatient and inpatient healthcare claims.

RESULTS:

The age standardized prevalence of hip osteoarthritis in adults aged 40 years or older is 6.18% (95% CI: ± 0.09%) among women and 6.02% (95% CI: ± 0.09%) among men. From the age of 75, sex differences become significant. The maximum number of newly diagnosed cases of hip osteoarthritis (women: 1.31%, men: 1.16%) is found in the 80 - 84-year-olds. From the age of 85, 17.4% of all women and 16.5% of all men show a hip osteoarthritis. The maximum number of hip replacement surgery among osteoarthritis patients (women: 5.2%, men: 4.3%) appears in the 75- to 79-year-olds. After the initial diagnosis of a hip osteoarthritis, every eighth (13.0%) AOK insured person receives a hip replacement surgery within the first year and one in four (24.8%) insurees within 8 years. Irrespective of the main diagnosis, numbers of hip replacement surgery did not increase between 2009 and 2016. On average, 300.9 (women) and 275.8 (men) hip replacement surgeries were performed per 100 000 insured years. From the age of 80, hip osteoarthritis drops back as the main diagnosis fur surgery. Consequently, from the age of 85 more than 70% of all hip replacement patients show a femoral fracture as main diagnosis. Only about ¾ of the hip osteoarthritis patients were in outpatient specialist care in the year before surgery, and far less than half of hip osteoarthritis patients received a referral to physiotherapy.

CONCLUSION:

Osteoarthritis of the hip occurs approximately equally often in women and men up to the age of 75 years. Nevertheless, women underwent surgery more frequently. Overall, the number of hip replacement surgery has not increased in the last eight years. Within the first eight years after initial diagnosis of hip osteoarthritis 24.8% of all patients receive a hip TEP. Hence, the majority of patients is treated conservatively in the first eight years. A direct comparison between incidence and prevalent hip osteoarthritis patients reveals that after many years of therapeutic care in the last 1 - 2 years prior to surgery, both the specialist care as well as the referral to physiotherapy are reduced. A reassessment of conservative treatment options over time seems to be necessary.

PMID:
30366348
DOI:
10.1055/a-0648-4945

Conflict of interest statement

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Supplemental Content

Full text links

Icon for Georg Thieme Verlag Stuttgart, New York
Loading ...
Support Center