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Effects of preoperative treatment on healthcare utilization and return to work for anterior cruciate ligament injuries: a real-world study using the French healthcare database

Title: Effects of preoperative treatment on healthcare utilization and return to work for anterior cruciate ligament injuries: a real-world study using the French healthcare database
Authors: Le Sant, Guillaume; Frouin, Antoine; Gachet, Lucie; Lacourpaille, Lilian; Nordez, Antoine; Bataille, Emmanuelle; Gaultier, Aurélie; Fournier, Jean-Pascal
Contributors: Motricité, interactions, performance UR 4334 / Movement - Interactions - Performance (MIP); Le Mans Université (UM)-Nantes Université - UFR des Sciences et Techniques des Activités Physiques et Sportives (Nantes Univ - UFR STAPS); Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ); Institut de Formation aux Métiers de la rééducation et de la réadaptation des Pays de la Loire (IFM3R); Préventions, Organisations et Parcours en Soins primaires (POPS); Université d'Angers (UA); Institut Sport Atlantique - St Herblain (ISA); Institut universitaire de France (IUF); Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.); Service de Santé publique Nantes; Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes); Unité méthodologique CHU Nantes (Département de recherche clinique); Nantes Université, Pôle fédératif des soins primaires, F-44035, Nantes; Département de médecine générale Nantes Université - UFR de Médecine et des Techniques Médicales (DMG Nantes); Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE)
Source: ISSN: 0091-3847 ; Physician and Sports Medicine ; https://hal.science/hal-04813507 ; Physician and Sports Medicine, 2024, pp.1-10. ⟨10.1080/00913847.2024.2435256⟩.
Publisher Information: CCSD; McGraw-Hill
Publication Year: 2024
Collection: Université de Nantes: HAL-UNIV-NANTES
Subject Terms: Physiotherapy modalities; exercise; primary health care; patient care management; knee; anterior cruciate ligament; [SDV]Life Sciences [q-bio]
Description: International audience ; Objective: To compare healthcare use and the number of days of sickness benefits between people with anterior cruciate ligament (ACL) injury who received physiotherapy before and after ACL reconstruction (ACLR) and those who received physiotherapy after ACLR only. Secondary aim: to measure the association between the volume of preoperative healthcare and post-ACLR recovery. Methods: Each individual's care pathway was extracted from a section of the French National Health Data System (SNDS) database (province: Pays de La Loire). The database was queried for the codes related to sickness benefits and healthcare utilization, including physiotherapy, medical and paramedical visits and procedures, medication, and medical equipment provided up to six months before and eighteen months after the ACLR. (Registry/number: ClinicalTrials.gov/NCT05737719). Results: Based on the timing of physiotherapy, two subcohorts were created from the database: 'prehabilitation' (n = 513) for those receiving physiotherapy before and after ACLR; 'no prehabilitation' (n = 630) for those only receiving physiotherapy after ACLR. Before ACLR, healthcare use was higher for the 'prehabilitation' group, including the number of medical visits (3.9 ± 2.3 vs. 3.0 ± 1.9 univariate p < 0.001), analgesia (mild opioids 60.4% vs. 49.8% univariate p < 0.001), dispensing of medical equipment (85.0% vs. 68.9% univariate p < 0.001) and sickness benefit days (52.7 ± 45.6 days vs. 33.2 ± 35.8 days, univariate p < 0.001). After ACLR, the 'prehabilitation' group underwent a higher number of physiotherapy sessions (46.8 ± 21.9 sessions vs 35.8 ± 19.0 sessions, p < 0.001) but had a similar number of sickness benefit days (94.7 ± 77.8 days vs 87.1 ± 69.9 days, p=0.092). From the multivariate analysis (n = 1143): age, comorbidities, the preoperative number of sickness benefit days, and the number of physiotherapy sessions before ACLR explained 24% of the variance in days of sickness benefits after ACLR. Conclusion: ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1080/00913847.2024.2435256
Availability: https://hal.science/hal-04813507; https://hal.science/hal-04813507v1/document; https://hal.science/hal-04813507v1/file/Le%20Sant%20et%20al%20%282024%29%20Phys%20SportsMed_HAL.pdf; https://doi.org/10.1080/00913847.2024.2435256
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.12F548F9
Database: BASE