Healthcare utilization patterns for knee and hip osteoarthritis before and after changes in national health insurance coverage: a data linkage study from the Netherlands.

Autor: Dros JT; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; National Health Care Institute, Diemen, the Netherlands; Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands. Electronic address: j.dros@nivel.nl., van Dijk CE; National Health Care Institute, Diemen, the Netherlands., Bos I; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands., Meijer WM; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands., Chorus A; National Health Care Institute, Diemen, the Netherlands., Miedema H; National Health Care Institute, Diemen, the Netherlands., Veenhof C; University Medical Centre Utrecht, Utrecht, the Netherlands., Arslan IG; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands., Meijboom BR; Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands., Verheij RA; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; National Health Care Institute, Diemen, the Netherlands; Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
Jazyk: angličtina
Zdroj: Health policy (Amsterdam, Netherlands) [Health Policy] 2023 Jul; Vol. 133, pp. 104825. Date of Electronic Publication: 2023 May 02.
DOI: 10.1016/j.healthpol.2023.104825
Abstrakt: Introduction: Medical guidelines aim to stimulate stepped care for knee and hip osteoarthritis, redirecting treatments from hospitals to primary care. In the Netherlands, this development was supported by changing health insurance coverage for physio/exercise therapy. The aim of this study was to evaluate healthcare utilization patterns before and after health changes in health insurance coverage.
Method: We analyzed electronic health records and claims data from patients with osteoarthritis in the knee (N = 32,091) and hip (N = 16,313). Changes between 2013 and 2019 in the proportion of patients treated by the general practitioner, physio/exercise therapist or orthopedic surgeon within 6 months after onset were assessed.
Results: Joint replacement surgeries decreased for knee (OR 0.47 [0.41-0.54]) and hip (OR 0.81 [0.71-0.93]) osteoarthritis between 2013-2019. The use of physio/exercise therapy increased (knee: OR 1.38 [1.24-1.53], hip: OR 1.26 [1.08-1.47]). However, the proportion treated by a physio/exercise therapist decreased for patients that had not depleted their annual deductibles (knee: OR 0.86 [0.79 - 0.94], hip: OR 0.90 [0.79 - 1.02]). This might be affected by the inclusion of physio/exercise therapy in basic health insurance in 2018.
Conclusion: We have found a shift from hospitals to primary care in knee and hip osteoarthritis care. However, the use of physio/exercise therapy declined after changes in insurance coverage for patients that had not depleted their deductibles.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
Externí odkaz: