Vo Anh Thu, Yi Yanqing, Mathews Maria, Valcour James, Alexander Michelle, Billard Marcel
Faculty of Medicine Memorial University of Newfoundland, St. John's Newfoundland Canada.
Schulich School of Medicine & Dentistry Western University London Ontario Canada.
Public Health Chall. 2023 Jul 12;2(3):e104. doi: 10.1002/puh2.104. eCollection 2023 Sep.
Single-entry models (SEM) improve wait times for hip and knee replacement, but little is known whether prioritization implemented in SEM can help meet the benchmarks for consolation/surgery. This study aimed to determine the impact of prioritization on receiving consultation and surgery within the benchmarks.
This is a retrospective cohort study for which two administration databases were linked. Logistic regression was used to investigate the impact of prioritization on receiving consultations and surgery within the benchmarks of 90 and 182 days, respectively, adjusting for patients' characteristics and preference for surgeon.
1,967 patients were included in this study. The odds ratios of having consultation within 90 days for hip replacement patients in priorities 1 and 2 (high priority) were 57.24 (CI: 23.16-141.47) and 14.63 (CI: 6.44-33.25), respectively, compared with those in priority 3. For knee replacement, patients with higher priority were more likely to have consultation within 90 days. Although priority levels were not related to having surgery within 182 days for knee replacement, hip replacement patients with priority 1 (CI: 0.2-0.75) and 2 (CI: 0.16-0.54) were less likely to have surgery within 182 days, compared with those with priority 3.
Patients with high priority levels were more likely to have consultation within 90 days for hip and knee replacements. SEM may not help have surgery within 182 days. Prioritization has no impact on receiving surgery within 182 days for knee replacement, but hip replacement patients with high priority were less likely to have surgery within 182 days.
单入组模型（SEM）可缩短髋关节和膝关节置换手术的等待时间，但对于SEM中实施的优先排序是否有助于达到会诊/手术基准，人们知之甚少。本研究旨在确定优先排序对在基准时间内接受会诊和手术的影响。
这是一项回顾性队列研究，将两个管理数据库进行了关联。采用逻辑回归分别研究优先排序对在90天和182天基准时间内接受会诊和手术的影响，并对患者特征和对医生的偏好进行了调整。
本研究纳入了1967例患者。与第3优先级的髋关节置换患者相比，第1和第2优先级（高优先级）的患者在90天内进行会诊的优势比分别为57.24（CI：23.16 - 141.47）和14.63（CI：6.44 - 33.25）。对于膝关节置换，优先级较高的患者更有可能在90天内进行会诊。虽然优先级与膝关节置换患者在182天内进行手术无关，但与第3优先级的患者相比，第1优先级（CI：0.2 - 0.75）和第2优先级（CI：0.16 - 0.54）的髋关节置换患者在182天内进行手术的可能性较小。
高优先级的患者在90天内进行髋关节和膝关节置换会诊的可能性更大。SEM可能无助于在182天内进行手术。优先排序对膝关节置换患者在182天内接受手术没有影响，但高优先级的髋关节置换患者在182天内进行手术的可能性较小。
