title: [Re-evaluation of the AOK hospital navigator with a focus on total knee replacement].
abstract: BACKGROUND
  One of the biggest health insurance companies in Germany (AOK, Allgemeine Ortskrankenkasse) has published new results focussing on process quality of total knee replacement in 2010. These results were published in the online portal "Weiße Liste", which is based on health insurance routine data. The German Association of Orthopeadic Surgery questions the credibility of the rating system of the "Weiße Liste". To prove the system an interdisciplinary task force was created.
  
  
  METHODS
  The task force identified patient-specific parameters, which influence the outcome of total knee replacement based on the literature and expert opinions. Out of 907 orthopaedic departments, 4 above average and four below average were identified. The AOK was asked to provide 80 data sets for each department. These anonymised data sets could be converted into patient-specific data sets in the identified departments. Statistical analysis was performed to answer the question of whether there are differences between the below and the above average groups.
  
  
  RESULTS
  625 cases could be investigated. We found an increased rate of postoperative complications in the below average group. There are differences between both groups in terms of factors influencing the procedure. In the below average group an increased rate of patients with one or more comorbidities and a preoperative extension lag of over 10° was found. The above average group has a higher rate of operations before the knee replacement.
  
  
  CONCLUSIONS
  The results need to be proven on a larger scale. Further, prospective investigations are planned.
authors: Klinik für Orthopädie, Uniklinik RWTH Aachen. c_luering@yahoo.de
authors: C
authors: C
authors: Lüring
authors: A
authors: A
authors: Freund
authors: S
authors: S
authors: Kirschner
authors: K-P
authors: KP
authors: Günther
authors: J
authors: J
authors: Malzahn
authors: C
authors: C
authors: Günster
authors: M
authors: M
authors: Tingart
authors: K-D
authors: KD
authors: Heller
authors: F-U
authors: FU
authors: Niethard
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000592:standards* / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D019317:Evidence-Based Medicine; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*