National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Arthritis (3)
- Back Health and Pain (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Diabetes (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (5)
- Healthcare Costs (4)
- Health Information Technology (HIT) (4)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Hospitalization (1)
- Hospitals (3)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Opioids (2)
- (-) Orthopedics (29)
- Outcomes (5)
- Pain (5)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (1)
- Payment (4)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (1)
- Rehabilitation (5)
- Research Methodologies (2)
- Risk (1)
- Shared Decision Making (3)
- Simulation (1)
- Surgery (25)
- Training (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 29 Research Studies DisplayedHerzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Ayers DC, Yousef M, Yang W
Age-related differences in pain, function, and quality of life following primary total knee arthroplasty: results from a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) cohort.
The purpose of this prospective, multicenter cohort study was to evaluate the differences in pain, function, and quality of life (QoL) reported 1 year after total knee arthroplasty (TKA) across varying age groups. The researchers preoperatively assessed 11,602 unilateral primary TKA patients, and collected demographic data, comorbid conditions, and patient-reported outcome measures including the knee injury and osteoarthritis outcome score (KOOS), KOOS-12, KOOS Joint Replacement, and Short-Form health survey (12-item) and then collected again at 1-year postoperatively. The study found that prior to surgery, patients less than 55 years reported worse KOOS pain (39), function (50), and QoL (18) scores with poor mental health score (47) than other older patient groups. At 1 year after TKA, patients less than 55 years reported lower KOOS pain, function, and QoL scores when compared to patients 75 years or older. The differences in score changes among the age groups were statistically significant but clinically irrelevant. Further statistical analyses revealed that age was a significant predictor for pain, but not for function at 1 year where KOOS pain score was predicted to be higher in patients 75 years or older when compared to patients less than 55 years of age.
AHRQ-funded; HS018910.
Citation: Ayers DC, Yousef M, Yang W .
Age-related differences in pain, function, and quality of life following primary total knee arthroplasty: results from a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) cohort.
J Arthroplasty 2023 Jul; 38(7 Suppl 2):S169-S76. doi: 10.1016/j.arth.2023.04.005..
Keywords: Orthopedics, Surgery, Quality of Life, Outcomes, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Pain
Ayers DC, Zheng H, Yang W
How back pain affects patient satisfaction after primary total knee arthroplasty.
This study looked at patient-reported outcomes (PROs) for patients with back pain (BP) who underwent total knee arthroscopy (TKA) surgery for pre- and postoperatively. This multicenter cohort study included 9,057 patients undergoing primary unilateral TKA who were enrolled in FORCE-TJ. Back pain (BP) intensity was assessed using the Oswestry back disability index (ODI) pain intensity questionnaire, with BP severity then classified into 4 categories. PROs were collected preoperatively and postoperatively after 1 year including the Knee injury and Osteoarthritis Outcome Score (KOOS) (total score, pain, Activities of Daily Living (ADL), and Quality of Life (QOL), Short-Form health survey 36-item (SF-36) Physical Component Score (PCS), and Mental Component Score (MCS)). At 1 year a total of 18.3% TKA patients were dissatisfied. At the time of surgery, a total of 4,765 patients (52.6%) reported back pain, divided into mild BP (24.9%), moderate (20.3%), and severe (7.2%). Severe back pain was significantly associated with patient dissatisfaction at 1 year after TKA. The predictive variables for dissatisfaction include age [odds ratio (OR) for younger patients <65 years versus older patients ≥65 years], educational level [OR for post high school versus less], smoking [OR for nonsmoker versus current smoker)], and Charlson comorbidity index [OR for CCI ≥2 versus 0]. The authors recommend surgeons consider a spine evaluation in patients who have severe BP prior to TKA.
AHRQ-funded; HS018910.
Citation: Ayers DC, Zheng H, Yang W .
How back pain affects patient satisfaction after primary total knee arthroplasty.
J Arthroplasty 2023 Jun; 38(6s):S103-s08. doi: 10.1016/j.arth.2023.03.072..
Keywords: Back Health and Pain, Pain, Pain, Patient Experience, Orthopedics, Surgery
Cochran A, Rayo MF
Toward joint activity design: augmenting user-centered design with heuristics for supporting joint activity.
This paper discusses the development of a clinical decision support application for preventing hospital-acquired infection called GeoHAI, which has yielded positive results in early usability testing and is expected to test positively in supporting joint activity, which will be measured through the novel implementation of Joint Activity Monitoring. The design and implementation of this application will help to unify the work of Human-Centered Design and Cognitive Systems Engineering through demonstration of the possibilities and necessities. The authors are calling this unified process Joint Activity Design, which supports designing for machines to be good team players.
AHRQ-funded; HS027200.
Citation: Cochran A, Rayo MF .
Toward joint activity design: augmenting user-centered design with heuristics for supporting joint activity.
Proc Int Symp Hum Factors Ergon Healthc 2023 Mar; 12(1):19-23. doi: 10.1177/2327857923121006..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Orthopedics
Carey K, Lin MY
Safety-net hospital performance under comprehensive care for joint replacement.
The objective of this study was to investigate the relative progress of safety-net hospitals (SNHs) under Medicare's Comprehensive Care for Joint Replacement (CJR) mandatory bundled payment model and to identify contributors to SNHs' realization of success under the CJR program. Secondary data on all CJR hospitals from 2016-2020 were taken from CMS public use files and from the American Hospital Association. The findings indicated that SNHs were less successful in meeting spending targets when compared to CJR hospitals overall. The authors concluded that the formula used by CMS to determine spending targets may not be sufficient to address disparities in SNH financial performances under mandatory bundled payment.
AHRQ-funded; HS027786.
Citation: Carey K, Lin MY .
Safety-net hospital performance under comprehensive care for joint replacement.
Health Serv Res 2023 Feb; 58(1):101-06. doi: 10.1111/1475-6773.14042..
Keywords: Hospitals, Surgery, Orthopedics, Provider Performance
Ko H, Martin BI, Nelson RE
How does the effect of the comprehensive Care for Joint Replacement model vary based on surgical volume and costs of care?
This article described differences in costs, quality, and patient selection between hospitals that continued to participate in the comprehensive Care for Joint Replacement (CJR) program after the CMS policy revision and those that withdrew from CJR before and after the implementation of CJR. Study subjects were Medicare beneficiaries who had undergone elective lower extremity joint replacement from 2013 to 2017. The results indicated that hospitals that continued to participate in CJR achieved a greater cost reduction. The authors noted that these the cost reductions were partly attributable to the avoidance of potential higher-cost patients.
AHRQ-funded; HS024714.
Citation: Ko H, Martin BI, Nelson RE .
How does the effect of the comprehensive Care for Joint Replacement model vary based on surgical volume and costs of care?
Med Care 2023 Jan;61(1):20-26. doi: 10.1097/mlr.0000000000001785..
Keywords: Orthopedics, Surgery, Healthcare Costs, Medicare, Payment
Konnyu KJ, Thoma LM, Cao W
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
This systematic review sought to examine evidence on the benefits and harms of prehabilitation interventions for patients scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. Evidence from 13 total knee arthroplasty studies suggested that prehabilitation may result in increased strength and reduced length of hospital stays and may not lead to increased harms; it may be comparable in terms of pain, range of motion, and activities of daily living. No evidence or insufficient evidence was found for all other outcomes after total knee arthroplasty. No evidence or insufficient evidence was found for all total hip arthroplasty outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):1-10. doi: 10.1097/phm.0000000000002006..
Keywords: Rehabilitation, Orthopedics, Evidence-Based Practice, Surgery
Konnyu KJ, Pinto D, Cao W
Rehabilitation for total hip arthroplasty: a systematic review.
This systematic review sought to determine the comparative benefits and harms of rehabilitation interventions for patients who had undergone elective, unilateral total hip arthroplasty (THA) for the treatment of primary osteoarthritis. Evidence from 15 studies suggested that individual rehabilitation programs may not differ in terms of risk of harm, outcomes of pain, strength, activities of daily living, or quality of life. No differences in outcomes were found between different rehabilitation programs after THA. The authors concluded that further evidence is needed to inform decisions on which rehabilitation program attributes are most effective for various outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Pinto D, Cao W .
Rehabilitation for total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):11-18. doi: 10.1097/phm.0000000000002007..
Keywords: Rehabilitation, Orthopedics, Surgery, Evidence-Based Practice
Konnyu KJ, Thoma LM, Cao W
Rehabilitation for total knee arthroplasty: a systematic review.
This systematic review sought to determine comparative benefits and harms of rehabilitation interventions for patients had undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. Evidence from 53 studies suggested that diverse rehabilitation programs may lead to comparable improvements in pain, range of motion, and activities of daily living. No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period nor among various postacute rehabilitation programs. All findings were of low strength of evidence.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Rehabilitation for total knee arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):19-33. doi: 10.1097/phm.0000000000002008..
Keywords: Rehabilitation, Surgery, Orthopedics, Evidence-Based Practice
Na A, Middleton A, Haas A
Impact of diabetes on 90-day episodes of care after elective total joint arthroplasty among Medicare beneficiaries.
This study examined the impact of diabetes on 90-day episodes of care after elective total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the United States. Complication (n = 521,230) and readmission (n = 515,691) data was extracted on Medicare beneficiaries using files from 2013 and 2014. Diabetes status was identified with ICD-9 codes. The odds ratio (OR) of TKA complications was significantly higher for patients with uncontrolled diabetes than those with no diabetes. The OR of THA complications was also significantly higher for controlled-complicated diabetes. OR of readmission was significantly higher for all diabetes groups.
AHRQ-funded; HS026133.
Citation: Na A, Middleton A, Haas A .
Impact of diabetes on 90-day episodes of care after elective total joint arthroplasty among Medicare beneficiaries.
J Bone Joint Surg Am 2020 Dec 16;102(24):2157-65. doi: 10.2106/jbjs.20.00203..
Keywords: Diabetes, Chronic Conditions, Orthopedics, Surgery
Bell KM, Onyeukwu C, Smith CN
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
The authors have developed and previously validated the accuracy of a remote (wearable) rehabilitation monitoring platform (interACTION). The present study's objective was to assess the feasibility of utilizing interACTION for the remote management of rehabilitation after total knee replacement (TKR) and to determine a preliminary estimate of the effects of the interACTION system on the value of rehabilitation. Findings showed that all patients and physical therapists in the interACTION Group indicated that they would use the system again in the future. Therefore, the next steps are to address the concerns identified in this pilot study and to expand the platform to include behavioral change strategies prior to conducting a full-scale randomized controlled trial.
Citation: Bell KM, Onyeukwu C, Smith CN .
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
Sensors 2020 Oct 27;20(21). doi: 10.3390/s20216118..
Keywords: Orthopedics, Rehabilitation, Health Information Technology (HIT)
Hsieh CJ, DeJong G, Vita M
AHRQ Author: Hsieh CJ
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
Researchers compared post-total knee arthroplasty (TKA) functional mobility outcomes among 3 newly-developed physical therapy protocols with a standard-of-care post-TKA rehabilitation protocol. They found no statistically or clinically significant differences in outcomes across the 4 study arms (control, treadmill, neuromuscular stimulation device, and combination intervention). As outcomes were similar among arms, they recommended that clinicians instead consider relative cost in tailoring TKA rehabilitation.
AHRQ-authored.
Citation: Hsieh CJ, DeJong G, Vita M .
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
JAMA Netw Open 2020 Sep;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571..
Keywords: Rehabilitation, Orthopedics, Surgery, Outcomes, Evidence-Based Practice
Giardina JC, Cha T, Atlas SJ
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
The purpose of this study was to develop and validate an algorithm to identify patients receiving four elective orthopedic surgeries to promote shared decision-making. The surgeries included were: 1) knee arthroplasty to treat knee osteoarthritis (KOA); 2) hip arthroplasty to treat hip osteoarthritis (HOA); 3) spinal surgery to treat lumbar spinal stenosis (SpS); and 4) spinal surgery to treat lumber herniated disc (HD). Electronic medical records were reviewed to ascertain a “gold standard” determination of the procedure and primary indication status. Each case had electronic algorithms consisting of ICD-10 and CPT codes for each combination and indication applied to their record. A total of 790 procedures were included in the study. The sensitivity of the algorithms ranged from 0.70 (HD) to 0.92 (KOA). Specificity ranged from 0.94 (SpS) to 0.99 (HOA, KOA).
AHRQ-funded; HS000055.
Citation: Giardina JC, Cha T, Atlas SJ .
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
BMC Med Inform Decis Mak 2020 Aug 12;20(1):187. doi: 10.1186/s12911-020-01175-1.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Orthopedics, Surgery, Arthritis, Shared Decision Making
Thomas GW, Long S, Tatum M
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
In this paper, a vision is presented to elevate community orthopedic practice and improve patient safety by advancing the use of simulators for training and assessing surgical skills. Key elements of this vision included 1) methods for the objective and rigorous assessment of the performance of practicing surgeons now exist, 2) simulators are sufficiently mature and sophisticated that practicing surgeons will use them, and 3) practicing surgeons can improve their performance with appropriate feedback and coaching.
AHRQ-funded; HS022077; HS025353.
Citation: Thomas GW, Long S, Tatum M .
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
Iowa Orthop J 2020;40(1):25-34..
Keywords: Orthopedics, Surgery, Simulation, Training, Provider: Physician, Provider
Machta RM, Reschovsky J, Jones DJ
AHRQ Author: Furukawa MF
Can vertically integrated health systems provide greater value: the case of hospitals under the comprehensive care for joint replacement model?
The authors sought to assess whether system providers perform better than non-system providers under an alternative payment model that incentivizes high-quality, cost-efficient care. Using CMS data linked to AHRQ’s Compendium of US Health Systems, along with secondary sources, they found that when operating under alternative payment model incentives, vertical integration may enable hospitals to lower costs with similar quality scores.
AHRQ-authored; AHRQ-funded; 290201600001C.
Citation: Machta RM, Reschovsky J, Jones DJ .
Can vertically integrated health systems provide greater value: the case of hospitals under the comprehensive care for joint replacement model?
Health Serv Res 2020 Aug;55(4):541-47. doi: 10.1111/1475-6773.13313..
Keywords: Health Systems, Hospitals, Orthopedics, Healthcare Costs, Payment, Quality of Care
Kittelson AJ, Elings J, Colborn K
Reference chart for knee flexion following total knee arthroplasty: a novel tool for monitoring postoperative recovery.
This study’s goal was to develop and validate a reference chart for monitoring recovery of knee flexion following total knee arthroplasty surgery. The researchers conducted a retrospective analysis of data collected for routine rehabilitation practice of post-TKA surgical patients. They concluded that a reference chart developed with clinically collected data offers a new approach to monitoring knee flexion following total knee arthroplasty.
AHRQ-funded; HS024316; HS025692.
Citation: Kittelson AJ, Elings J, Colborn K .
Reference chart for knee flexion following total knee arthroplasty: a novel tool for monitoring postoperative recovery.
BMC Musculoskelet Disord 2020 Jul 22;21(1):482. doi: 10.1186/s12891-020-03493-x..
Keywords: Orthopedics, Surgery
Goz V, Martin BI, Donnally CJ
Potential selection bias in observational studies comparing cervical disc arthroplasty to anterior cervical discectomy and fusion.
This retrospective cohort study looked at potential selection bias for spinal patients undergoing cervical disc arthroplasty (CDA) or anterior cervical discectomy and fusion (ACDF). A total of ACDF or CDA 290,419 procedures were identified in adults from 2004-2014 using ICD-9-CM diagnosis and procedure codes. The vast majority (98.2%) underwent ACDF. CDA patients were younger and healthier with a higher socioeconomic status than ACDF patients. CDA was also $574 more expensive in the fully specified model. There was no statistically significant difference in terms of complications between the two procedures.
AHRQ-funded; HS024714.
Citation: Goz V, Martin BI, Donnally CJ .
Potential selection bias in observational studies comparing cervical disc arthroplasty to anterior cervical discectomy and fusion.
Spine 2020 Jul 15;45(14):960-67. doi: 10.1097/brs.0000000000003427..
Keywords: Surgery, Orthopedics, Research Methodologies
Loyd BJ, Kittelson AJ, Forster J
Development of a reference chart to monitor postoperative swelling following total knee arthroplasty.
The purpose of this study was to develop a reference chart to monitor postoperative swelling following total knee arthroplasty. Until recently, there was no reliable way to accurately measure swelling in clinical settings, but bioelectrical impedance assessment has shown promise. The authors worked with 56 participants who were followed for the first 7 weeks following total knee arthroplasty. Frequent lower extremity bioelectrical impedance assessment data was collected from the first 40 patients rolled in the study with the remaining 16 patients preliminarily tested. The first 3 days following surgery showed an approximately 10% per day increase with peak swelling occurring 6-8 days after surgery, with a range of 25% for the 10th percentile and 47% for the 90th percentile. It is hoped this monitoring will improve clinical decision making at the individual level.
AHRQ-funded; HS024316.
Citation: Loyd BJ, Kittelson AJ, Forster J .
Development of a reference chart to monitor postoperative swelling following total knee arthroplasty.
Disabil Rehabil 2020 Jun;42(12):1767-74. doi: 10.1080/09638288.2018.1534005..
Keywords: Surgery, Orthopedics
Weng Y, Tian L, Tedesco D
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Postoperative pain scores are widely monitored and collected in the electronic health record, yet current methods fail to fully leverage the data with fast implementation. This article describes a trajectory analysis for postoperative pain using electronic health records. A robust linear regression was fitted to describe the association between the log-scaled pain score and time from discharge after total knee replacement.
AHRQ-funded; HS024096.
Citation: Weng Y, Tian L, Tedesco D .
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Health Informatics J 2020 Jun;26(2):1404-18. doi: 10.1177/1460458219881339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Pain, Surgery, Orthopedics, Research Methodologies, Health Services Research (HSR)
Dekhne MS, Nuliyalu U, Schoenfeld AJ
"Surprise" out-of-network billing in orthopedic surgery: charges from surprising sources.
This study examined “surprise” out-of-network billing in orthopedic surgery. Data was analyzed from the Clinformatics DataMart on commercial insured patients undergoing 4 different elective orthopedic procedures from 2012 to 2017: arthroscopic meniscal repair, lumbar discectomy, total knee replacement and total hip replacement. They defined surprise bills as out-of-network bills for procedures done at in-network hospitals. The rate of potential surprise bills was 24.8% for total knee replacement, 24.5% lumbar discectomy, 23.5% for total hip replacement, and 12.5% for meniscal repair. The largest number of surprise bills came from anesthesiologists (39% of all episodes), and durable medical equipment (15%). Per episode, the largest bills came from nonphysician surgical assistants, neurologists, and physician assistants.
AHRQ-funded; HS000053; HS023597.
Citation: Dekhne MS, Nuliyalu U, Schoenfeld AJ .
"Surprise" out-of-network billing in orthopedic surgery: charges from surprising sources.
Ann Surg 2020 May;271(5):e116-e18. doi: 10.1097/sla.0000000000003825..
Keywords: Orthopedics, Surgery, Payment, Healthcare Costs, Health Insurance
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Shared Decision Making, Racial and Ethnic Minorities, Women
Whitebird RR, Solberg LI, Norton RR, Solberg LI, Norton CK
What outcomes matter to patients after joint or spine surgery?
In this study, semi-structured interviews were conducted with 65 patients undergoing hip or knee replacement, spinal discectomy/laminectomy, or a spinal fusion to examine what patient-reported outcome measures (PROMs) patients identified as most important. The investigators found that patients identified specific preferred outcomes from these surgical procedures that were important and meaningful to them and that framed whether they saw their surgery as a success. They also identified personal factors that they assumed their surgeons knew about, which affected their care and recovery.
AHRQ-funded; HS025618.
Citation: Whitebird RR, Solberg LI, Norton RR, Solberg LI, Norton CK .
What outcomes matter to patients after joint or spine surgery?
J Patient Cent Res Rev 2020 Spr;7(2):157-64. doi: 10.17294/2330-0698.1738..
Keywords: Surgery, Orthopedics, Patient-Centered Outcomes Research, Outcomes
Finch DJ, Martin BI, Franklin PD
Patient-reported outcomes following total hip arthroplasty: a multicenter comparison based on surgical approaches.
This study looked at patient-reported outcomes (PROs) from patients who underwent total hip arthroplasty (THA) in the United States. The cohort examined were participants in the Comparative Effectiveness of Pulmonary Embolism Prevention after Hip and Knee Replacement study. The researchers compared PROs between posterior, transgluteal, and anterior surgical approaches to THA. Patients were surveyed on function, global health and pain at 1, 3, and 6 months postoperatively at 26 sites from the clinical trial. Outcomes from 3018 eligible participants were examined from December 2016 through August 2019. While there was lower improvement in hip disability and Osteoarthritis Outcomes Score at first with the transgluteal cohort, by 3 and 6 months there was no clinically significant differences between the three groups.
AHRQ-funded; HS024714.
Citation: Finch DJ, Martin BI, Franklin PD .
Patient-reported outcomes following total hip arthroplasty: a multicenter comparison based on surgical approaches.
J Arthroplasty 2020 Apr;35(4):1029-35.e3. doi: 10.1016/j.arth.2019.10.017..
Keywords: Orthopedics, Surgery
Finch DJ, Pellegrini VD, Franklin PD
The effects of bundled payment programs for hip and knee arthroplasty on patient-reported outcomes.
This study compared outcomes for patients undergoing hip and knee arthroplasty at hospitals participating in Medicare’s bundled payment programs with hospitals that do not. They performed a prospective observational study using the Comparative Effectiveness of Pulmonary Embolism Prevention after Hip and Knee replacement trial. Differences through 6 months were observed. Outcomes were described using the brief Knee Injury and Osteoarthritis Outcomes Score or the brief Hip Disability and Osteoarthritis Outcomes Score, the Patient-Reported Outcomes Measurement Information System Physical Health Score, and the Numeric Pain Rating Scale. While there slightly lower improvement at nonbundled hospitals at first, overall the effects were small.
Citation: Finch DJ, Pellegrini VD, Franklin PD .
The effects of bundled payment programs for hip and knee arthroplasty on patient-reported outcomes.
J Arthroplasty 2020 Apr;35(4):918-25.e7. doi: 10.1016/j.arth.2019.11.028..
Keywords: Orthopedics, Surgery, Payment
Kittelson AJ, Hoogeboom TJ, Schenkman M
Person-centered care and physical therapy: a "people-like-me" approach.
In this article the authors propose developing "people-like-me" reference charts, generated with historical outcomes data, to provide real-time information on an individual's status relative to similar people, using as an example people rehabilitating after total knee arthroplasty. The authors propose this framework as a practical mechanism to advance person-centered decisions in physical therapy according to the ideals of evidence-based practice.
AHRQ-funded; HS024316; HS025692.
Citation: Kittelson AJ, Hoogeboom TJ, Schenkman M .
Person-centered care and physical therapy: a "people-like-me" approach.
Phys Ther 2020 Jan 23;100(1):99-106. doi: 10.1093/ptj/pzz139..
Keywords: Patient-Centered Healthcare, Surgery, Orthopedics