title: Regional variation in orthopedic surgery in Switzerland.
abstract: The study systematically describes the frequency and geographic variability of major surgical interventions for musculoskeletal disorders in Switzerland. Age- and sex-standardized rates for joint replacements, arthroscopies, spine surgery and hip fracture repair were calculated for hospital service regions. Various statistical analyses were used to measure the extent of variation. The authors argue that the surgery of hip fractures can be used as index surgery in the context of analyzing variations in orthopedic surgery. Temporal trends imply that patient demand and supply factors related to clinical ambiguity and non-medical incentives of providers are far more important components leading to increased use than the sole effect of an aging population.
authors.affiliation: University of Bern, Institute for Evaluative Research in Orthopaedic Surgery, Stauffacherstrasse 78, CH-3014 Bern, Switzerland. marcel.widmer@memcenter.unibe.ch
authors.forename: Marcel
authors.initials: M
authors.lastname: Widmer
authors.forename: Pius
authors.initials: P
authors.lastname: Matter
authors.forename: Lukas
authors.initials: L
authors.lastname: Staub
authors.forename: Franziska
authors.initials: F
authors.lastname: Schoeni-Affolter
authors.forename: André
authors.initials: A
authors.lastname: Busato
mesh_terms: D005260:Female; D005843:Geography; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000601:surgery; D009985:Orthopedics / Q000706:statistics & numerical data / Q000639:trends*; D010351:Patient Discharge / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology