For the first time, the Canadian Institute for Health Information (CIHI) is releasing an analysis focusing on the 12 most common implantable medical device (IMD) procedures provided in hospitals across the country each year.
In 2018–2019, there were nearly 707,000 hospitalizations and day surgeries involving these high-volume or high-cost IMDs. The most common procedures were cataract lens insertions (58%), followed by knee replacements (11%) and hip replacements (9%). For most of the procedures analyzed, half of the recipients were age 65 and older. Overall, women underwent the majority (55%) of IMD procedures, but there were differences for specific IMDs. The total hospital cost for these procedures is estimated at $3.7 billion annually.
IMDs have a wide range of applications to help improve and extend lives, from reducing ear infections in children to keeping blood pumping through the heart and helping to restore sight. This report looks at volumes and trends, patient characteristics and associated costs of hospital-based IMD procedures. It also identifies opportunities to increase the availability of data needed to monitor the effectiveness and safety of IMDs.
Infections are leading cause of early joint revision surgeries
In conjunction with the IMD report, CIHI is also releasing a new outcome study focused on knee and hip replacement procedures.
This report focuses on an important quality issue: revision (or repeat) surgeries needed within 2 years of the initial knee or hip replacement. A revision surgery is needed to either replace or fix the initial joint replacement. The data shows that about a third of early revision surgeries are due to preventable infections, a serious and costly complication of joint replacement. Early revisions due to infections cost over 2 times more than the initial surgery, and costs can increase significantly for more complex cases. Early revisions also have a large negative impact on patients’ quality of life.
Typically, a joint replacement is expected to last for about 15 years, so surgeries that take place within 2 years are considered avoidable.
“As Canada’s population ages and medical device technology advances, more Canadians will receive implantable medical devices. These devices can provide valuable benefits, but not all patients have positive experiences. We now know that many patients undergo early revision knee and hip replacements, which are costly and negatively impact patients. More data about the safety and effectiveness of these procedures can improve patient experiences and outcomes.” — Greg Webster, Director, Acute and Ambulatory Care Information Services
About the data
Implantable Medical Devices in Canada: Insights Into High-Volume Procedures and Associated Costs focuses on 12 IMD procedures. These were selected based on high procedure volumes or high costs observed in CIHI databases, as well as on the medical literature and consultations with stakeholders.
These 12 IMD procedures are cataract lens insertion, knee replacement, hip replacement, coronary stent, ear tube, pacemaker, intrauterine device (IUD), spinal fusion and fixation hardware, transvaginal mesh implant and tension-free vaginal tape (TVT), breast implant prosthesis, shoulder replacement and defibrillator.
The in-depth outcome data for knee and hip replacement procedures comes from the Canadian Joint Replacement Registry (CJRR). CJRR, managed by CIHI, is Canada’s only national medical device registry. Launched in 2001, it’s a collaborative effort with the Canadian Orthopaedic Association. We collect patient-specific information (clinical, surgical and prosthesis) on knee and hip replacement surgeries performed in Canada.
You can find more information about wait times for some of these procedures in our Wait Times web tool.
The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization dedicated to providing essential health information to all Canadians.
CIHI works closely with federal, provincial and territorial partners and stakeholders throughout Canada to gather, package and disseminate information to inform policy, management, care and research, leading to better and more equitable health outcomes for all Canadians.
Health information has become one of society’s most valuable public goods. For 25 years, CIHI has set the pace on data privacy, security, accessibility and innovation to improve Canada’s health systems.
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