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What effect have NHS commissioners’ policies for body mass index had on access to knee replacement surgery in England?: An interrupted time series analysis from the National Joint Registry

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  • Joanna McLaughlin
  • Ruth Kipping
  • Amanda Owen-Smith
  • Hugh McLeod
  • Samuel Hawley
  • J Mark Wilkinson
  • Andrew Judge

Abstract

Objective: To assess the impact of local commissioners’ policies for body mass index on access to knee replacement surgery in England. Methods: A Natural Experimental Study using interrupted time series and difference-in-differences analysis. We used National Joint Registry for England data linked to the 2015 Index of Multiple Deprivation for 481,555 patients who had primary knee replacement surgery in England between January 2009 and December 2019. Clinical Commissioning Group policies introduced before June 2018 to alter access to knee replacement for patients who were overweight or obese were considered the intervention. The main outcome measures were rate per 100,000 of primary knee replacement surgery and patient demographics (body mass index, Index of Multiple Deprivation, independently-funded surgery) over time. Results: Rates of surgery had a sustained fall after the introduction of a policy (trend change of -0.98 operations per 100,000 population aged 40+, 95% confidence interval -1.22 to -0.74, P

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  • Joanna McLaughlin & Ruth Kipping & Amanda Owen-Smith & Hugh McLeod & Samuel Hawley & J Mark Wilkinson & Andrew Judge, 2022. "What effect have NHS commissioners’ policies for body mass index had on access to knee replacement surgery in England?: An interrupted time series analysis from the National Joint Registry," PLOS ONE, Public Library of Science, vol. 17(6), pages 1-17, June.
    • Handle: RePEc:plo:pone00:0270274
    DOI: 10.1371/journal.pone.0270274
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