ArticlePloS one2018
Unwarranted regional variation in vertebroplasty and kyphoplasty in Switzerland: A population-based small area variation analysis.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Increased Use and Large Variation in Strong Opioids and Metamizole (Dipyrone) for Minor and Major Musculoskeletal Injuries Between 2008 and 2018: An Analysis of a Representative Sample of Swiss Workers.Journal of occupational rehabilitation · 2024Article
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- Long-term follow-up after vertebroplasty - A mean 10-years follow-up control study.Brain & spine · 2024Article
- The Swiss health care atlas-relaunch in scale.Research in health services & regions · 2023Article
- Algorithmic hospital catchment area estimation using label propagation.BMC health services research · 2022Article
- Variation in regional implantation patterns of cardiac implantable electronic device in Switzerland.PloS one · 2022Article
- Trends and regional variation in vertebroplasty and kyphoplasty in Switzerland: a population-based small area analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Health and social behaviour through pandemic phases in Switzerland: Regional time-trends of the COVID-19 Social Monitor panel study.PloS one · 2021Article
- High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.PloS one · 2021Article
- Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study.BMC health services research · 2020Article
- Article
- Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis.PloS one · 2020Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPercutaneous vertebroplasty (VP) and balloon kyphoplasty (BKP) for treating painful osteoporotic vertebral fractures are controversial.
objectiveWe assessed the regional variation in the use of VP/BKP in Switzerland.
methodsWe conducted a population-based small area variation analysis using patient discharge data for VP/BKP from all Swiss hospitals and Swiss census data for calendar years 2012/13. We derived hospital service areas (HSAs) by analyzing patient flows, assigning regions from which most residents were discharged to the same VP/BKP specific HSA. We calculated age-/sex-standardized mean VP/BKP-rates and measures of regional variation (extremal quotient [EQ], systematic component of variation [SCV]). We estimated the reduction in variation of VP/BKP rates using negative binomial regression, with adjustment for patient demographic and regional socioeconomic factors (socioeconomic status, urbanization, and language region). We considered the residual, unexplained variation most likely to be unwarranted.
resultsOverall, 4955 VP/BKPs were performed in Switzerland in 2012/13. The age-/sex-standardized mean VP/BKP rate was 4.6/10,000 persons and ranged from 1.0 to 10.1 across 26 HSAs. The EQ was 10.2 and the SCV 57.6, indicating a large variation across VP/BKP specific HSAs. After adjustment for demographic and socioeconomic factors, the total reduction in variance was 32.2% only, with the larger part of the variation remaining unexplained.
conclusionsWe found a 10-fold variation in VP/BKP rates across Swiss VP/BKP specific HSAs. As only one third of the variation was explained by differences in patient demographics and regional socioeconomic factors, VP/BKP in the highest-use areas may, at least partially, represent overtreatment.
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