ArticleActa orthopaedica2024
Regional variation in low-value musculoskeletal surgery: a nationwide study from the Finnish Care Register.
Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Uncertainty and risk of misleading conclusions: an umbrella review of the quality of the evidence for ankle arthroscopy.Acta orthopaedica · 2025Pooled it
- Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.BMJ (Clinical research ed.) · 2025Trial
- Regional Variation in Wrist Ligament Surgery Incidence: A 25-year Nationwide Register Study.Plastic and reconstructive surgery. Global open · 2026Article
- Nationwide trends and variations in reverse shoulder arthroplasty in Japan: national database analysis 2014-2023.JSES international · 2026Article
- The sensitivity of patient-reported outcome measures in surgical and non-surgical care: a systematic review and meta-epidemiological evaluation of randomised controlled trials.EClinicalMedicine · 2026Article
- Surgical Low-Value Care Between Fee-For-Service and Salaried Health Care Systems.JAMA network open · 2025Article
- Nationwide incidence of lateral malleolar fracture surgery across 6 European countries: has recent evidence changed clinical practice?Acta orthopaedica · 2025Article
- Postoperative infection, wrong-site surgery, and patient death after elective low-value orthopedic surgery: the epitome of preventable surgical complications.Patient safety in surgery · 2025Article
- Changes in radiocarpal and intercarpal arthrodesis incidence in Sweden: A 16-year retrospective analysis of 5 189 surgeries.PloS one · 2025Observational
- National trends of wrist arthroscopy in Italy: Analysis from 2001 to 2016.Journal of experimental orthopaedics · 2025Article
- Letter to the Editor: Regional variation in low-value musculoskeletal surgery: a nationwide study from the Finnish Care Register.Acta orthopaedica · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeHealthcare systems globally are grappling with resource constraints and rising costs. Concerns have been raised about "low-value" care, which consumes healthcare resources without benefiting patients. We aimed to examine regional differences in common low-value musculoskeletal surgeries in Finland and explore explanatory factors behind the variation.
methodsUsing data from the Finnish Care Register for Health Care, surgeries conducted from 2006-2007 compared with 2020-2021 were analyzed across 20 hospital districts. Selected surgeries (acromioplasty, rotator cuff repair, partial meniscectomy, wrist arthroscopy, ankle arthroscopy, and distal radius fracture fixation) were categorized based on NOMESCO procedure codes, and incidence rates in older populations were calculated based on population size derived from Statistics Finland.
resultsWe found substantial regional disparities in low-value surgeries. The incidence rates were higher in hospitals with high historical incidence rates and smaller population sizes, suggesting that the uptake of evidence is slower in small non-academic hospitals.
conclusionThe incidence of low-value surgery is declining but regional differences remain large. It is unlikely that regional variation in disease incidence explains such large variation in low-value surgery. Instead, local treatment culture seems to be the driving force behind low-value surgery, and the practices seem to be more entrenched in small hospitals.
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