[Determining the indication for primary total hip and knee replacement. Results of external quality assurance of over 270,000 primary total hip and knee replacements].
BACKGROUND
The German mandatory quality assurance programme collects data from all primary total hip and knee replacements. The quality of the indication is measured by clinical and radiological criteria. The results were analysed in terms of differences in establishing the indication subject to patient and hospital characteristics.


METHODS
Data on more than 270,000 primary total hip and knee replacements that were operated in 2006 in Germany were analysed concerning differences in the quality of the indication subject to age, gender, hospital volume and density of population and hospitals (metropolitan vs rural areas). The statistical analysis was done by exact Fisher's test.


RESULTS
The quality of the indication was statistically significantly better in men, patients 60 and older, in rural areas and in high volume hospitals (50 and more joint replacements per year).


CONCLUSIONS
Data of this mandatory German quality assurance programme are useful to describe differences in medical care. The results are valid and complete. An exact analysis of the reasons for these differences is difficult though. Data focus is on quality assurance and represent only in-hospital results.


CONCLUSIONS
Further analyses are necessary to ascertain whether the differences in quality of care are deficits or only variances in medical care.
Schräder
P
P
BQS Bundesgeschäftsstelle Qualitätssicherung, Kanzlerstrasse 4, 40472, Düsseldorf, Deutschland. peter.schraeder@bqs-online.de
Boy
O
O
Schleiz
W
W
Dienst
R
R
Reinert
C
C
Sänger
V
V
Schauwecker
H-H
HH
Siebert
W
W
Scharf
H-P
HP
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000592:standards / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000592:standards / Q000706:statistics & numerical data; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D012424:Rural Population; D012737:Sex Factors; D014505:Urban Population