Knee replacement surgery declined after NHS patient weight policies were introduced

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New research has found that weight/body mass index (BMI) policies introduced by NHS commissioning groups in England are associated with fewer knee replacement surgeries and may contribute to health inequalities. With one in ten people likely to need knee replacement surgery, several thousand patients are directly affected by these policies.

The study funded by the National Institute for Health and Care Research (NIHR), led by the University of Bristol and published in PLOS ONE today, suggest regions that have introduced Politics changes for access to knee replacement surgery based on a patient’s weight/BMI have seen a drop in surgery.

Over the past decade, rules have been bought by NHS Clinical Commissioning Groups (CCGs) across England to change access to hip and knee replacement surgery for patients in overweight or obese. However, there are many regional differences, with some regions having no such policy and, in the strictest examples, patients being denied access to elective hip or knee replacement surgery until their BMI is below a certain threshold.

The research team analyzed the knee replacement rates of 481,555 patients between January 2009 and December 2019 using data from the National joint register and regions compared with and without IMC policy.

The aim of the research was to investigate the effect of these commissioning policies on access to elective knee surgery and whether there was evidence of worsening health inequalities by a disproportionate effect on the less affluent groups of society.

The study found that policies put in place by NHS CCGs to alter access to knee replacement surgery based on patient weight/BMI are linked to less surgery and may have led to postcode-related health inequalities.

Research has highlighted that the rules can worsen health inequalities, as the introduction of the policies may be linked to an increase in the number of patients seeking private surgery and a reduction in the number of the most economically disadvantaged patients. undergoing surgery.

Surgery rates have fallen in all patient groups, not just for overweight or obese people the patientswho the policy was intended for.

Dr Joanna McLaughlin, NIHR Doctoral Fellow at Bristol Medical School: Translational Health Sciences (THS) and lead author of the study, said: “NHS policy on giving people immediate access to a reference for knee arthroplasty surgery whether they are overweight or obese varies depending on where you live in England.

“Our study raises concern that these policies are linked to an increase in health inequalities with fewer NHS operations for the less wealthy groups in society when policies are introduced. »

Research team urges commissioners and policymakers to reconsider restrictive policies that affect access to elective courses operation emergency. The researchers also suggest that the recent formation of integrated care systems from existing CCG groups is an important opportunity for positive changes to political position.


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More information:
What effect have NHS commissioners’ body mass index policies had on access to knee replacement surgery in England? : An analysis of interrupted time series from the National Joint Registry, PLOS ONE (2022). DOI: 10.1371/journal.pone.0270274

Quote: Knee replacement surgery down after introduction of NHS patient weight policies (2022, June 29) Retrieved June 29, 2022 from https://medicalxpress.com/news/2022-06-knee- surgery-decreased-nhs-policies.html

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