Area variation in the use of surgical interventions such as arthroplasty is viewed as concerning and inappropriate.
To determine whether area arthroplasty rates reflect patient-related demand factors, we estimated the need for and the willingness to undergo arthroplasty in a high- and a low-use area of Ontario, Canada.
Population-based mail and telephone survey.
All adults aged > or =55 years in a high (n = 21,925) and low (n = 26,293) arthroplasty use area.
We determined arthritis severity and comorbidity with questionnaires, established the presence of arthritis with examination and radiographs, and evaluated willingness to have arthroplasty with interviews. Potential arthroplasty need was defined as severe arthritis, no absolute contraindication for surgery, and evidence of arthritis on examination and radiographs. Estimates of need were then adjusted for patients' willingness to undergo arthroplasty.
Response rates were 72.0% for questionnaires and interviews. The potential need for arthroplasty was 36.3/1,000 respondents in the high-rate area compared with 28.5/1,000 in the low-rate area (P
Comment In: Med Care. 2001 Mar;39(3):203-511242315