Health equity profile of knee replacement patients in the South African public sector: A descriptive study.
Marisa Coetzee, Amanda M Clifford, Jacobus D Jordaan and 1 others
PMID 39114425WHAT IT FOUND
One in three knee replacement patients at a South African public hospital waited over five years.
Older patients and those with lower socioeconomic status waited significantly longer. More than half reported severe mobility issues and pain, with many experiencing anxiety and depression.
Key findings
01One in three patients on the waiting list has been waiting for longer than 5 years.
02Patients older than 70 years waited significantly longer than younger groups, often having aged on the list after being added at a younger age.
03Patients who were not fully subsidised by the state (who must pay a percentage of costs) were significantly less likely to wait long for surgery compared to fully subsidised patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted at a single tertiary hospital in an urban setting, so the results may not apply to rural areas or other hospitals. No patients from rural areas participated, which limits the generalisability to remote populations who may face different barriers. The study took place during the height of the COVID-19 pandemic, which influenced waiting lists and service availability. Data collection relied on electronic records that were sometimes incomplete or delayed due to scanning issues. The study design is cross-sectional, so it describes associations at one point in time but cannot prove that specific equity factors caused the waiting times.
Declared interests
The authors declared no conflicts of interest. The study was part of a PhD project approved by Stellenbosch University.
The easy way to misread this
Do not assume that all patients waiting for knee replacement have similar access barriers. The study found that patients who were not fully subsidised by the state waited significantly less time than those who were fully subsidised, suggesting that socioeconomic status and ability to pay influence waiting times.