The pathway to orthopaedic surgery: a population study of the role of access to primary care and availability of orthopaedic services in Ontario, Canada.
Bottom Line: Access to PCPs and the index of geographic availability of orthopaedic surgeons, but not SES, were significantly associated with orthopaedic surgeon office visits.There was a significant interaction between access to PCPs and orthopaedic surgeon geographic availability for the rate of office visits, with access to PCPs being more important in areas of low geographic availability of orthopaedic surgeons.The findings suggest that, particularly, in areas with low access to PCPs or with fewer available orthopaedic surgeons, residents are less likely to have orthopaedic surgeon office visits and in turn are less likely to receive surgery.
Affiliation: The Arthritis Community Research and Evaluation Unit, Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Ontario, Canada Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.Show MeSH
Related in: MedlinePlus
Mentions: In the 2007/2008 fiscal year there were 477 000 individuals with office visits to orthopaedic surgeons, 132 600 individuals with orthopaedic surgery for MSD, and almost 2.4 million individuals made at least one visit to PCPs for MSD in Ontario. Table 1 presents summary data for use of orthopaedic surgeon services, access to PCPs and the geographic availability of orthopaedic surgeons’ index. Almost 5% of the population made at least one office visit to orthopaedic surgeons, and 1.5% had an orthopaedic surgery. One-quarter of the population 18 years and older made at least one visit to PCPs for MSD in Ontario with a fourfold variation in the rate across health planning areas. The median distance to the nearest orthopaedic surgeon was 11.5 km and ranged up to 342 km. Nevertheless 97.5% of the population lived within 50 km of an orthopaedic surgeon. The median geographic availability of orthopaedic surgeons’ index (using a 50 km radius) was 57 h/week/100 000 population with a sevenfold variation across the health planning areas (figure 2).
Affiliation: The Arthritis Community Research and Evaluation Unit, Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Ontario, Canada Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.