德国和美国的髋关节和膝关节置换：对 2005 年至 2011 年德国和美国医院的个别住院病人数据进行分析。
Hip and knee replacement in Germany and the USA: analysis of individual inpatient data from German and US hospitals for the years 2005 to 2011.
机构信息
Department for Structural Advancement and Quality Manangement in Health Care at Technische Universität Berlin.
出版信息
Dtsch Arztebl Int. 2014 Jun 9;111(23-24):407-16. doi: 10.3238/arztebl.2014.0407.
BACKGROUND
The number of hip and knee replacement operations is rising in many industrialized countries. To evaluate the current situation in Germany, we analyzed the frequency of procedures in Germany compared to the USA, with the aid of similar case definitions and taking demographic differences into account.
METHODS
We used individual inpatient data from Germany (DRG statistics) and the USA (Nationwide Inpatient Sample) to study differences in the age- and sex-adjusted rates of hip and knee replacement surgery and the determinants of trends in case numbers over the years 2005 to 2011.
RESULTS
In 2011, hip replacement surgery was performed 1.4 times as frequently in Germany as in the USA (284 vs. 204 cases per 100 000 population per year; the American figures have been adjusted to the age and sex structure of the German population). On the other hand, knee replacement surgery was performed 1.5 times as frequently in the USA as in Germany (304 [standardized] vs. 206 cases per 100,000 population per year). Over the period of observation, the rates of both procedures increased in both countries. The number of elective primary hip replacement operations in Germany grew by 11%, from 140,000 to 155 300 (from 170 to 190 per 100,000 persons); after correction for demographic changes, a 3% increase remained. At the same time, the rate of elective primary hip replacement surgery in the USA rose by 28%, from 79 to 96 per 100 000 population, with a 13% increase remaining after correction for demographic changes.
CONCLUSION
There are major differences between Germany and the USA in the frequency of these operations. The observed upward trend in elective primary hip replacement operations was mostly due to demographic changes in Germany; non-demographic factors exerted a stronger influence in the USA than in Germany. With respect to primary knee replacement surgery, non-demographic factors exerted a comparably strong influence in both countries.
背景
在许多工业化国家，髋关节和膝关节置换手术的数量正在增加。为了评估德国的现状，我们分析了德国与美国手术频率的比较，使用了类似的病例定义，并考虑了人口统计学差异。
方法
我们使用了德国（DRG 统计）和美国（全国住院患者样本）的个体住院数据，研究了 2005 年至 2011 年期间年龄和性别调整后的髋关节和膝关节置换手术比率以及病例数量趋势的决定因素。
结果
2011 年，德国髋关节置换手术的频率是美国的 1.4 倍（每 10 万人每年 284 例与 204 例；美国的数据已根据德国人口的年龄和性别结构进行了调整）。另一方面，美国膝关节置换手术的频率是德国的 1.5 倍（每 10 万人每年 304 例[标准化]与 206 例）。在观察期间，两国的手术率都有所增加。德国选择性初次髋关节置换手术的数量增长了 11%，从 14 万例增加到 15.53 万例（每 10 万人 170 例增加到 190 例）；经人口统计学变化校正后，增长率仍为 3%。与此同时，美国选择性初次髋关节置换手术的比例上升了 28%，从每 10 万人 79 例增加到 96 例，经人口统计学变化校正后，增长率仍为 13%。
结论
德国和美国在这些手术的频率上存在很大差异。选择性初次髋关节置换手术的上升趋势主要归因于德国的人口统计学变化；而非人口统计学因素对美国的影响比德国更大。对于初次膝关节置换手术，非人口统计学因素在两国都产生了相当大的影响。
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