Waikato Medical Research Centre, The University of Waikato, Hamilton 3240, New Zealand.
Orthopaedic Department, Tauranga Hospital, Tauranga 3143, New Zealand.
Int J Environ Res Public Health. 2019 Nov 29;16(23):4789. doi: 10.3390/ijerph16234789.
This study aims to explore the length of stay (LOS) of publicly funded osteoarthritic primary hip and knee replacement surgeries in New Zealand. Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgery in 2005-2017 were included. We have identified 53,439 osteoarthritic primary hip replacements and 50,072 osteoarthritic primary knee replacements. LOS has been reduced by almost 40% over the last 13 years. Logistic regression showed that women, Māori, Pacific and Asian patients, older patients, people with more comorbidities and those having opiates on discharge and patients in earlier years were more likely to have extended LOS following hip replacements and knee replacements. Regional differences were noted in LOS between the Waitemata District Health Board (DHB) compared to Tairāwhiti DHB where patients were the most likely to have a LOS of more than 5 days after hip and knee replacements. LOS after hip and knee replacements has been reduced dramatically. Women, Māori, Pacific and Asian patients, older patients and people with more comorbidities are more likely to have extended LOS. Patients dispensed opiates on discharge had a longer LOS. There are great geographical variations in LOS for primary hip and knee surgeries in New Zealand.
本研究旨在探讨新西兰公共资助的骨关节炎初次髋关节和膝关节置换手术的住院时间（LOS）。研究对象为 2005 年至 2017 年期间接受公共资助初次髋关节和膝关节置换手术的骨关节炎患者。我们共确定了 53439 例骨关节炎初次髋关节置换术和 50072 例骨关节炎初次膝关节置换术。在过去的 13 年中，LOS 减少了近 40%。逻辑回归显示，女性、毛利人、太平洋岛民和亚裔患者、年龄较大的患者、合并症较多的患者以及出院时使用阿片类药物的患者，以及更早年份的患者，在髋关节和膝关节置换术后 LOS 延长的可能性更高。在 LOS 方面，怀塔克雷地区卫生委员会（Waitemata District Health Board）与泰阿雷地区卫生委员会（Tairāwhiti DHB）之间存在区域差异，后者的患者髋关节和膝关节置换术后 LOS 超过 5 天的可能性最大。髋关节和膝关节置换术后 LOS 显著缩短。女性、毛利人、太平洋岛民和亚裔患者、年龄较大的患者以及合并症较多的患者，LOS 延长的可能性更高。出院时开具阿片类药物的患者 LOS 更长。新西兰初次髋关节和膝关节手术的 LOS 存在较大的地域差异。
