ArticleBMC musculoskeletal disorders2025
Disparity in access to orthopedic surgery between public and private healthcare insurance: a nationwide population-based study.
Article in BMC musculoskeletal disorders, 2025. 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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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.
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Who cites it
1 citing paper in PubMed.
- Introducing dual practice may threaten equitable surgical access in Canada.Lancet regional health. Americas · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to evaluate if access to orthopedic surgery differs by healthcare coverage in a country with a dual healthcare system adjusted by age, sex, and urgent and elective conditions. We hypothesize that differential access would exist according to the type of healthcare coverage. This difference would accentuate when analyzing access to elective orthopedic surgery.
methodsA cross-sectional, population-based design was used to investigate orthopedic surgery rates in Chile in 2018. The rates of orthopedic surgeries provided under the private and public healthcare systems were calculated per 1,000 inhabitants based on data collected from the Hospital Discharge Registry provided by the Chilean Ministry of Health. ICD-10 diagnoses were classified as urgent or elective, categories into which the public/private surgery rates were also sorted.
resultsThe overall rate of orthopedic surgery was 7.54 per 1000 inhabitants in 2018. Patients covered under private insurance had an orthopedic surgery rate 2.23 times higher than patients within the public system (p-value < 0.001). This difference became more accentuated when sorting by elective surgeries, with private healthcare having a rate 2.97 times higher than public healthcare (p-value < 0.001). In the multivariate analysis, significant differences were observed in the rates of orthopedic surgery, being higher in the private system, elective surgeries, and older adults. No significant differences were observed according to sex (p-value 0.270).
conclusionsIn Chile, access disparity to orthopedic surgical care existed between private and public healthcare systems, elective surgeries, and older age groups. Disparity in access became greater when separately analyzing the rates of elective and urgent orthopedic surgeries. LEVEL OF EVIDENCE: III.
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