Utilization rates of hip arthroplasty in OECD countries.
BACKGROUND
Hip arthroplasty and revision surgery is growing exponentially in OECD countries, but rates vary between countries.


METHODS
We extracted economic data and utilization rates data about hip arthroplasty done in OECD countries between 1990 and 2011. Absolute number of implantations and compound annual growth rates were computed per 100,000 population and for patients aged 65 years old and over and for patients aged 64 years and younger.


RESULTS
In the majority of OECD countries, there has been a significant increase in the utilization of total hip arthroplasty in the last 10 years, but rates vary to a great extent: In the United States, Switzerland, and Germany the utilization rate exceeds 200/100,000 population whereas in Spain and Mexico rates are 102 and 8, respectively. There is a strong correlation between gross domestic product (GDP) and health care expenditures per capita with utilization rate. Utilization rates in all age groups have continued to rise up to present day. A seven fold higher growth rate was seen in patients aged 64 years and younger as compared to older patients.


CONCLUSIONS
We observed a 38-fold variation in the utilization of hip arthroplasty among OECD countries, correlating with GDP and health care expenditures. Over recent years, there has been an increase in the utilization rate in most countries. This was particularly evident in the younger patients. Due to increasing life expectancy and the disproportionally high use of arthroplasty in younger patients we expect an exponential increase of revision rate in the future.
EAR (European Arthroplasty Register) Scientific Office, Innsbruck, Austria; Medical University of Graz, Plüddemanngasse 45, 8010 Graz, Austria. Electronic address: christof.pabinger@medunigraz.at.
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Pabinger
Department of Health Care Management, WHO Collaborating Centre for Health Systems Research and Management, Berlin University of Technology, Straße des 17. Juni 135, H80 10623 Berlin, Germany. Electronic address: a.geissler@tu-berlin.de.
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Geissler
D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006622:Hip Prosthesis / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D066150:Organisation for Economic Co-Operation and Development; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D018579:Patient Selection; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
Epidemiology; Hip; Replacement; Revision; Total hip arthroplasty; Utilization rate