Evidence map›Paper›PMID 38012311›Full record

ArticleInternational orthopaedics2024

Impact of the coronavirus disease 2019 pandemic on equity of access to hip and knee replacements: a population-level study.

Seper Ekhtiari, Daniel Pincus, Ruth Croxford, Jodi M Gatley, Amir Khoshbin, Amit Atrey, J Michael Paterson, Bheeshma Ravi

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Article in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Seper EkhtiariAddenbrooke's - Cambridge University Hospitals, University of Cambridge, Cambridge, UK. seper.ekhtiari@gmail.com.ORCID 0000-0002-4571-9655
Daniel PincusDepartment of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada.
Ruth CroxfordICES, Toronto, Ontario, Canada.
Jodi M GatleyICES, Toronto, Ontario, Canada.
Amir KhoshbinICES, Toronto, Ontario, Canada.
Amit AtreyICES, Toronto, Ontario, Canada.
J Michael PatersonICES, Toronto, Ontario, Canada.
Bheeshma RaviDepartment of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe COVID-19 pandemic had innumerable impacts on healthcare delivery. In Canada, this included limitations on inpatient capacity, which resulted in an increased focus on outpatient surgery for non-emergent cases such as joint replacements. The objective of this study was to assess whether the pandemic and the shift towards outpatient surgery had an impact on access to joint replacement for marginalized patients.

methodsData from Ontario's administrative healthcare databases were obtained for all patients undergoing an elective hip or knee replacement between January 1, 2018 and August 31, 2021. All surgeries performed before March 15, 2020 were classified as "pre-COVID," while all procedures performed after that date were classified as "post-COVID." The Ontario Marginalization Index domains were used to analyze proportion of marginalized patients undergoing surgery pre- and post-COVID.

resultsA total of 102,743 patients were included-42,812 hip replacements and 59,931 knee replacements. There was a significant shift towards outpatient surgery during the post-COVID period (1.1% of all cases pre-COVID to 13.2% post-COVID, p < 0.001). In the post-COVID cohort, there were significantly fewer patients from some marginalized groups, as well as fewer patients with certain co-morbidities, such as congestive heart failure and chronic obstructive pulmonary disease.

conclusionThe most important finding of this population-level database study is that, compared to before the COVID-19 pandemic, there has been a change in the profile of patients undergoing hip and knee replacements in Ontario, specifically across a range of indicators. Fewer marginalized patients are undergoing joint replacement surgery since the COVID-19 pandemic. Further monitoring of access to joint replacement surgery is required in order to ensure that surgery is provided to those who are most in need.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeCOVID-19Health Services AccessibilityHumansPandemicsCOVID-19Hip and knee replacementsICESTotal joint arthroplasty

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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.