ArticlePloS one2020
Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- Association between health care insurance type and rates of visceral surgical procedures in Switzerland. A population-based weighted retrospective cohort study.BMC public health · 2026Article
- Strategies to Implement Knee Osteoarthritis Guidelines in Switzerland.Public health reviews · 2026Article
- Mapping and managing geographic variation in elective surgeries through user-friendly data presentation: insights from Tuscany region.Research in health services & regions · 2025Review
- Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review.BMC health services research · 2025Article
- Characterization of spatial integrity with active and passive implants in a low-field magnetic resonance linear accelerator scanner.Physics and imaging in radiation oncology · 2024Article
- Article
- Article
- Article
- The Swiss health care atlas-relaunch in scale.Research in health services & regions · 2023Article
- Comparison of Cardiovascular Procedure Rates in Patients With Supplementary vs Basic Insurance in Switzerland.JAMA network open · 2023Article
- Variation in regional implantation patterns of cardiac implantable electronic device in Switzerland.PloS one · 2022Article
- High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.PloS one · 2021Article
- Health and social behaviour through pandemic phases in Switzerland: Regional time-trends of the COVID-19 Social Monitor panel study.PloS one · 2021Article
- Association between immigration status and total knee arthroplasty outcomes in Ontario, Canada: a population-based matched cohort study.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCompared to other OECD countries, Switzerland has the highest rates of hip (HA) and knee arthroplasty (KA).
objectiveWe assessed the regional variation in HA/KA rates and potential determinants of variation in Switzerland.
methodsWe conducted a population-based analysis using discharge data from all Swiss hospitals during 2013-2016. We derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-/sex-standardized procedure rates and measures of variation (the extremal quotient [EQ, highest divided by lowest rate] and the systemic component of variation [SCV]). We estimated the reduction in variance of HA/KA rates across HSAs in multilevel regression models, with incremental adjustment for procedure year, age, sex, language, urbanization, socioeconomic factors, burden of disease, and the number of orthopedic surgeons.
resultsOverall, 69,578 HA and 69,899 KA from 55 HSAs were analyzed. The mean age-/sex-standardized HA rate was 265 (range 179-342) and KA rate was 256 (range 186-378) per 100,000 persons and increased over time. The EQ was 1.9 for HA and 2.5 for KA. The SCV was 2.0 for HA and 2.2 for KA, indicating a low variation across HSAs. When adjusted for procedure year and demographic, cultural, and sociodemographic factors, the models explained 75% of the variance in HA and 63% in KA across Swiss HSAs.
conclusionSwitzerland has high HA/KA rates with a modest regional variation, suggesting that the threshold to perform HA/KA may be uniformly low across regions. One third of the variation remained unexplained and may, at least in part, represent differing physician beliefs and attitudes towards joint arthroplasty.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.