Continuing the trend towards private provision of hip arthroplasties is likely to result in risk selection and is not expected to widen inequalities in England, concludes new research published in the Journal of the Royal Society of Medicine.
The study, carried out by researchers at Newcastle University and Queen Mary University of London, analysed data on NHS-funded elective hip operations in England from 2003/2004 to 2012/2013 to calculate the annual crude and standardised rates of hip arthroplasties per 100,000 population performed by NHS and private providers.
Provision shifted from NHS providers to private providers from 2007/2008. NHS provision decreased 8.6 per cent and private provision increased 188 per cent between 2007/2008 and 2012/2013.
Private sector hip arthroplasties on NHS patients from the most affluent areas increased 228 per cent between 2007/2008 and 2012/2013 from 10.8 (95% CI, 10.2-11.5) per 100,000 to 35.4 (95% CI, 34.3-36.5) per 100,000. This compared to an increase of 186 per cent from 8.8 (95% CI, 8.1-9.4) to 25.2 (95% CI, 24.1-26.4) per 100,000 among patients from the least affluent areas.
There was no statistically significant widening in inequalities in overall NHS-funded hip arthroplasties during the study period. The authors suggest this was due to the protective and buffering effects of NHS provision which remained the predominant provider.