AVÐÇÇò

For this analysis, we categorized hip and knee replacement patients by subgroups (i.e., age group, recorded sex or gender, neighbourhood income and geographic location) using AVÐÇÇò’s pan-Canadian guidance on equity stratifiers.Reference1

This work was completed in 2 parts:

• Analysis of each data measure separately, examining results by patient socio-demographic factor and presenting the results together (see the data in brief) 
• Analysis of linked data sets to examine correlations across the different measures: PREMs and clinical outcomes; PREMs and PROMs; and hospitalization costs and PROMs (see Table 1)

Supplementary data tables for this report provide counts by patient subgroups for all results, and additional PREMs-only results by education level and racialized group. 

A step-by-step methodology report and an analysis by joint type (hip or knee) are available upon request from AVÐÇÇò at proms@cihi.ca. 

• Compared with younger age groups, patients age 75 and older had higher rates of hospital harm and readmission to hospital; lower favourable patient experiences; lower change in functional status, quality of life and satisfaction with surgery; and higher inpatient hospitalization costs. 
• Male patients had higher rates of readmission to hospital, revision surgery and favourable patient experiences; however, female patients had higher rates of hospital harm.
• Compared with patients in higher-income neighbourhoods, patients in lower-income neighbourhoods had higher rates of hospital harm, readmission to hospital and revision surgery; lower satisfaction with surgery; and higher inpatient hospitalization costs.
• Patients in rural/remote areas had higher rates of readmission to hospital compared with patients in urban areas, whereas patients in urban areas had higher rates of hospital harm compared with patients in rural/remote areas.

The Hospital Harm results presented in the data in brief are consistent with AVÐÇÇò’s Hospital Harm Results, 2014–2015 to 2022–2023 (XLSX), which show higher crude rates of hospital harm for patients 65 and older, patients in the lowest neighbourhood income quintile and patients living in urban locations.Reference2 In addition, the results for Involvement in Decision-Making and Treatment Options are consistent with AVÐÇÇò’s Patient experience in Canadian hospitals, 2022 report, which found that older patients feel that they are less involved in decision-making and treatment options compared with younger patients.Reference3

• Equity stratifiers
• Looking at PREMs through the lens of health equity
• Hospital Harm Project