Abstract
Objective To descriptively analyze surgical interventions performed in Chile in middle-aged and older adults with meniscal pathology between 2016 and 2018, including the type of healthcare system as an important factor.
Materials and Methods We performed a descriptive analysis of the hospital discharges database of the Chilean Ministry of Health between 2016 and2018. The cases were selected according to the diagnostic discharge codes of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), which were crossed with surgical intervention codes of the Chilean National Health Fund (Fondo Nacional de Salud, FONASA, in Spanish) regarding meniscectomy.
Results A total of 21,424 interventions in 139 medical facilities were performed during the period analyzed. In 51.3% of the cases, the procedures were performed in middle-aged adults (10,983 cases). Older adults underwent 2,254 interventions (10.5%), and both groups encompass 61.8% of all observed cases. The patients who underwent arthroscopic partial meniscectomy (APM) using diagnosis-related payment (pago asociado a un diagnóstico, PAD, in Spanish) were significantly older (p < 0.01). The 3 medical facilities that with the highest rates of surgeries performed are all private centers that offer the PAD modality and concentrate 26% of all cases.
Discussion In Chile, most meniscal surgeries are performed in patients in age groups that the literature considers to be controversial. Although many possible explanations exist, we deem this fact important for public health, considering that FONASA, which covers most patients in the Chilean public system, is capable of financing a large part of the surgery through the PAD modality.
Conclusions Meniscal surgeries in Chile are mostly performed in patients in the age group in which their usefulness is most questionable.
Level of evidence IV.
Keywords
knee arthroscopic surgery - menisci - meniscectomy - osteoarthritis
