Higher prices don't imply better care for patients undergoing joint replacement

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The prices that insurers negotiate for total joint replacement (TJR) procedures vary widely according to type of insurer and aren't associated with conventional measures of health care quality, according to a study in Clinical Orthopaedics and Related Research (CORR).

There was no correlation between the average negotiated price and any of four measures of the quality of care: the TJR complication rate, the need for hospital readmission after surgery, patients' ratings of their care, and overall hospital performance score. Neither was there any association between price and theseEfforts to improve the value of TJR care depend on informing patients

Dr. Kamal and his colleagues note that patients need access to price and quality information that's linked together. They propose that surgeons determine appropriate measures of TJR quality, combine them with price information, and present the results in decision aids—tools such as brochures and charts that help patients make more informed choices about surgery.

"Other strategies for reporting care quality and price include surgeon scorecards and institutional value dashboards [online reports at websites], which have been piloted in orthopedic surgery with promising results," the authors say."Hospitals should combine them with price information and present the results transparently to help patients make more informed choices about surgery.

 

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