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Predicting the burden of revision knee arthroplasty: Simulation of a 20-Year Horizon

Predicting the burden of revision knee arthroplasty: Simulation of a 20-Year Horizon
Predicting the burden of revision knee arthroplasty: Simulation of a 20-Year Horizon
Objectives
To estimate future utilization scenarios for knee arthroplasty (KA) revision in the Spanish National Health System in the short- and long-term and their impact on primary KA utilization.

Methods
A discrete-event simulation model was built to represent KA utilization for 20 years (2012–2031) in the Spanish National Health System. Data on KA utilization from 1997 to 2011 were obtained from the minimum data set. Three scenarios of future utilization of primary KA (1, fixed number since 2011; 2, fixed age- and sex-adjusted rates since 2011; and 3, projection using a linear regression model) were combined with two prosthesis survival functions (W [worse survival], from a study including primary KA from 1995 to 2000; and B [better survival], from the Catalan Registry of Arthroplasty, including primary KA from 2005 to 2013). The simulation results were analyzed in the short-term (2015) and the long-term (2030).

Results
Variations in the number of revisions depended on both the primary utilization rate and the survival function applied, ranging from increases of 8.3% to 31.6% in the short- term and from 38.3% to 176.9% in the long-term, corresponding to scenarios 1-B and 3-W, respectively. The prediction of increases in overall surgeries ranged from 0.1% to 22.3% in the short-term and from 3.7% to 98.2% in the long-term.

Conclusions
Projections of the burden of KA provide a quantitative basis for future policy decisions on the concentration of high-complexity procedures, the number of orthopedic surgeons required to perform these procedures, and the resources needed.
1098-3015
680-687
Guerrero-ludueña, Richard E.
db129ad5-e7f4-427c-b834-34fd22d67537
Comas, Mercè
d6bdbaa3-4517-48e1-a700-0c75ea2456cb
Espallargues, Mireia
9ac6e4bc-4f4e-4b2d-b286-6a4667bd2512
Coll, Moisès
ec25e73a-bf1d-468a-a7cf-0410b31a6251
Pons, Miquel
5ac48cb1-f0db-4ef8-9447-d6ac303fb61f
Sabatés, Santiago
c5086390-4c6b-4597-b922-e7ccda53fe53
Allepuz, Alejandro
644179cf-d776-4f58-95dc-e063f2491ca6
Castells, Xavier
3b668e30-1e36-4616-bf53-cebb478868dc
Guerrero-ludueña, Richard E.
db129ad5-e7f4-427c-b834-34fd22d67537
Comas, Mercè
d6bdbaa3-4517-48e1-a700-0c75ea2456cb
Espallargues, Mireia
9ac6e4bc-4f4e-4b2d-b286-6a4667bd2512
Coll, Moisès
ec25e73a-bf1d-468a-a7cf-0410b31a6251
Pons, Miquel
5ac48cb1-f0db-4ef8-9447-d6ac303fb61f
Sabatés, Santiago
c5086390-4c6b-4597-b922-e7ccda53fe53
Allepuz, Alejandro
644179cf-d776-4f58-95dc-e063f2491ca6
Castells, Xavier
3b668e30-1e36-4616-bf53-cebb478868dc

Guerrero-ludueña, Richard E., Comas, Mercè, Espallargues, Mireia, Coll, Moisès, Pons, Miquel, Sabatés, Santiago, Allepuz, Alejandro and Castells, Xavier (2016) Predicting the burden of revision knee arthroplasty: Simulation of a 20-Year Horizon. Value in Health, 19 (5), 680-687. (doi:10.1016/j.jval.2016.02.018).

Record type: Article

Abstract

Objectives
To estimate future utilization scenarios for knee arthroplasty (KA) revision in the Spanish National Health System in the short- and long-term and their impact on primary KA utilization.

Methods
A discrete-event simulation model was built to represent KA utilization for 20 years (2012–2031) in the Spanish National Health System. Data on KA utilization from 1997 to 2011 were obtained from the minimum data set. Three scenarios of future utilization of primary KA (1, fixed number since 2011; 2, fixed age- and sex-adjusted rates since 2011; and 3, projection using a linear regression model) were combined with two prosthesis survival functions (W [worse survival], from a study including primary KA from 1995 to 2000; and B [better survival], from the Catalan Registry of Arthroplasty, including primary KA from 2005 to 2013). The simulation results were analyzed in the short-term (2015) and the long-term (2030).

Results
Variations in the number of revisions depended on both the primary utilization rate and the survival function applied, ranging from increases of 8.3% to 31.6% in the short- term and from 38.3% to 176.9% in the long-term, corresponding to scenarios 1-B and 3-W, respectively. The prediction of increases in overall surgeries ranged from 0.1% to 22.3% in the short-term and from 3.7% to 98.2% in the long-term.

Conclusions
Projections of the burden of KA provide a quantitative basis for future policy decisions on the concentration of high-complexity procedures, the number of orthopedic surgeons required to perform these procedures, and the resources needed.

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More information

e-pub ahead of print date: 23 April 2016
Published date: 1 July 2016

Identifiers

Local EPrints ID: 429195
URI: http://eprints.soton.ac.uk/id/eprint/429195
ISSN: 1098-3015
PURE UUID: 73a534fd-7593-479b-a2a5-fd0106f3244a
ORCID for Richard E. Guerrero-ludueña: ORCID iD orcid.org/0000-0002-1217-015X

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Date deposited: 22 Mar 2019 17:30
Last modified: 03 Dec 2019 01:33

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Contributors

Author: Mercè Comas
Author: Mireia Espallargues
Author: Moisès Coll
Author: Miquel Pons
Author: Santiago Sabatés
Author: Alejandro Allepuz
Author: Xavier Castells

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