Temporal trends in medical device implant procedures in Australia 2008–22: evidence from the Australian Institute of Health and Welfare National Hospital Morbidity database

Mohammad Afshar Ali; Thu-Lan Kelly; Marianne Gillam

doi:10.1071/AH23126

RESEARCH ARTICLE (Open Access)

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Temporal trends in medical device implant procedures in Australia 2008–22: evidence from the Australian Institute of Health and Welfare National Hospital Morbidity database

Mohammad Afshar Ali

^A ^* , Thu-Lan Kelly

^B and Marianne Gillam

^A

+ Author Affiliations

- Author Affiliations

^A Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.

^B Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.

^* Correspondence to: afshar0506@gmail.com

Australian Health Review https://doi.org/10.1071/AH23126

Submitted: 24 May 2023 Accepted: 22 May 2024 Published: 17 June 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

Examine the temporal trends in medical device implant procedures in the Australian population.

Methods

We used data from the Australian Institute of Health and Welfare from the financial years 2007–08 to 2021–22 and chose the most frequently performed medical device implant procedures. We estimated the annual change in volume of procedures and age-standardised rates by calculating the compound annual growth rate (CAGR), and used regression with the Newey–West robust variance estimator to examine whether there was a linear trend in the age-standardised rates for each procedure.

Results

For procedures including cardiac pacemakers, heart valves, hip and knee arthroplasties, and intraocular lenses, the crude CAGR was over 3%. For the age-standardised rates, the CAGR was largest for cardiac pacemaker, followed by heart valve replacement and hip arthroplasty procedures. For some procedures, the growth was more than in the Australian population, including cardiac pacemakers (β = 1.00; 95% CI: 0.14–1.86), heart valve replacements (β = 0.41; 95% CI: 0.28–0.54), hip arthroplasty (β = 3.50; 95% CI: 1.61–5.38), and knee arthroplasty (β = 4.31; 95% CI: 0.54–8.09) procedures. The trend of standardised rates of procedures, including incisional hernia with mesh, breast implants, coronary stents, and cardiac defibrillators, grew at the same rate as the population, whereas the rate for gastric banding procedures decreased (β = −3.14; 95% CI: −4.92 to −1.34).

Conclusion

The findings from the current study, showing a large increase in medical device implant procedures, will assist in future healthcare planning and efforts in post-market surveillance of safety of medical devices.

Keywords: Australia, healthcare, medical device implants, medical procedure, trend analysis.

References

1 Medical Technology Association of Australia Limited. Medical Technology in Australia: Key facts and figures 2013, Occasional Paper Series. Sydney: Medical Technology Association of Australia; 2013.

2 Inacio MCS, Graves SE, Pratt NL, Roughead EE, Nemes S. Increase in Total Joint Arthroplasty Projected from 2014 to 2046 in Australia: A Conservative Local Model With International Implications. Clin Orthop Relat Res 2017; 475(8): 2130-7.
| Crossref | Google Scholar | PubMed |

3 Ackerman IN, Bohensky MA, Zomer E, Tacey M, Gorelik A, Brand CA, et al. The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030. BMC Musculoskelet Disord 2019; 20(1): 90.
| Crossref | Google Scholar | PubMed |

4 Wamble DE, Ciarametaro M, Dubois R. The Effect of Medical Technology Innovations on Patient Outcomes, 1990–2015: Results of a Physician Survey. J Manag Care Spec Pharm 2019; 25(1): 66-71.
| Crossref | Google Scholar | PubMed |

5 Lee A-H, Ng ACC, Yong ASC, Hyun K, Brieger D, Kritharides L, et al. Outcomes of 1,098 Patients Following Transcatheter Aortic Valve Implantation: A Statewide Population-Linkage Cohort Study. Heart Lung Circ 2021; 30(8): 1213-20.
| Crossref | Google Scholar | PubMed |

6 Gada H, Kapadia SR, Tuzcu EM, Svensson LG, Marwick TH. Markov Model for Selection of Aortic Valve Replacement Versus Transcatheter Aortic Valve Implantation (Without Replacement) in High-Risk Patients. Am J Card 2012; 109(9): 1326-33.
| Crossref | Google Scholar | PubMed |

7 Pabinger C, Lothaller H, Portner N, Geissler A. Projections of hip arthroplasty in OECD countries up to 2050. Hip Int 2018; 28(5): 498-506.
| Crossref | Google Scholar | PubMed |

8 Lewis PL, Graves SE, Robertsson O, Sundberg M, Paxton EW, Prentice HA, et al. Increases in the rates of primary and revision knee replacement are reducing: a 15-year registry study across 3 continents. Acta Orthop 2020; 91(4): 414-9.
| Crossref | Google Scholar | PubMed |

9 Jiramongkolchai P, Lander DP, Kallogjeri D, Olsen MA, Keller M, Schneider JS, et al. Trend of surgery for orbital cellulitis: An analysis of state inpatient databases. Laryngoscope 2020; 130(3): 567-74.
| Crossref | Google Scholar | PubMed |

10 Köckerling F, Hoffmann H, Mayer F, Zarras K, Reinpold W, Fortelny R, et al. What are the trends in incisional hernia repair? Real-world data over 10 years from the Herniamed registry. Hernia 2021; 25(2): 255-65.
| Crossref | Google Scholar | PubMed |

11 Pawlak M, Tulloh B, de Beaux A. Current trends in hernia surgery in NHS England. Ann R Coll Surg Engl 2020; 102(1): 25-7.
| Crossref | Google Scholar | PubMed |

12 Landes U, Bental T, Levi A, Assali A, Vaknin-Assa H, Lev EI, et al. Temporal trends in percutaneous coronary interventions thru the drug eluting stent era: Insights from 18,641 procedures performed over 12-year period. Catheter Cardiovasc Interv 2018; 92(4): E262-E70.
| Crossref | Google Scholar | PubMed |

13 Gillam MH, Pratt NL, Inacio MCS, Roughead EE, Shakib S, Nicholls SJ, et al. Heart failure after conventional metal-on-metal hip replacements. Acta Orthop 2017; 88(1): 2-9.
| Crossref | Google Scholar | PubMed |

14 Lenzer J. Medical device industry: international investigation exposes lax regulation. BMJ 2018; 363: k4997.
| Crossref | Google Scholar | PubMed |

15 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE I. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370(9596): 1453-7.
| Crossref | Google Scholar | PubMed |

16 AIHW. Procedures Data Cubes, National Hospital Morbidity Database. AIHW; 2021.

17 ABS. National, state and territory population. Canberra: ABS; 2022.

18 Zeileis A, Lumley T, Berger S, Graham N, Zeileis MA. Package ‘sandwich’: 3-0.03. 2021. Available at https://cran.r-project.org/web/packages/sandwich/sandwich.pdf

19 Bowman R. Sooner or later? The sequential bilateral cataract surgery debate. Sydney: Insight; 2022.

20 Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet 2017; 390(10094): 600-12.
| Crossref | Google Scholar | PubMed |

21 Bothun ED, Cavalcante LCB, Hodge DO, Patel SV. Population-based Incidence of Intraocular Lens Exchange in Olmsted County, Minnesota. Am J Ophthalmol 2018; 187: 80-6.
| Crossref | Google Scholar | PubMed |

22 Kanthan GL, Wang JJ, Rochtchina E, Tan AG, Lee A, Chia E-M, et al. Ten-Year incidence of age-telated cataract and cataract surgery in an older Australian population: The Blue Mountains Eye Study. Ophthalmology 2008; 115(5): 808-14 e1.
| Crossref | Google Scholar | PubMed |

23 Zecchin M, Torre M, Carrani E, Sampaolo L, Ciminello E, Ortis B, et al. Seventeen-year trend (2001–2017) in pacemaker and implantable cardioverter-defibrillator utilization based on hospital discharge database data: An analysis by age groups. Eur J Intern Med 2021; 84: 38-45.
| Crossref | Google Scholar | PubMed |

24 Bradshaw PJ, Stobie P, Knuiman MW, Briffa TG, Hobbs MST. Trends in the incidence and prevalence of cardiac pacemaker insertions in an ageing population. Open Heart 2014; 1(1): e000177.
| Crossref | Google Scholar | PubMed |

25 Bamford P, Said C, Al-Omary MS, Bhagwandeen R, Boyle A. Aortic Valve Replacement Rates in Australia from 2004 to 2019. Intern Med J 2021; 53: 525-530.
| Crossref | Google Scholar |

26 Inacio MCS, Paxton EW, Graves SE, Namba RS, Nemes S. Projected increase in total knee arthroplasty in the United States - an alternative projection model. Osteoarthr Cartil 2017; 25(11): 1797-803.
| Crossref | Google Scholar | PubMed |

27 Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty 2022 Annual Report. Adelaide: Australian Orthopaedic Association National Joint Replacement Registry; 2022.

28 Chung AY, Strassle PD, Schlottmann F, Patti MG, Duke MC, Farrell TM. Trends in Utilization and Relative Complication Rates of Bariatric Procedures. J Gastrointest Surg 2019; 23(7): 1362-72.
| Crossref | Google Scholar | PubMed |

29 AIHW. Elective surgery. AIHW; 2022.

30 AIHW. Impact of COVID–19 on hospital care. AIHW; 2022.

31 TGA. Database of Adverse Event Notifications - medical devices. TGA; 2022.

32 Craig A, O’Meley P, Carter P. The need for greater reporting of medical device incidents. Innovations 2019; 3: 56-63.
| Google Scholar |

33 de Steiger RN, Hallstrom BR, Lübbeke A, Paxton EW, van Steenbergen LN, Wilkinson M. Identification of implant outliers in joint replacement registries. EFORT Open Rev 2023; 8(1): 11-7.
| Crossref | Google Scholar | PubMed |

34 Williams ML, Hutchinson AG, Oh DD, Young CJ. Trends in Australian inguinal hernia repair rates: a 15-year population study. ANZ J Surg 2020; 90(11): 2242-7.
| Crossref | Google Scholar | PubMed |