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Measuring value, impact of orthopedic care

Date:
November 26, 2013
Source:
Journal of Bone and Joint Surgery
Summary:
A recent article demonstrates that "value" in healthcare is not a nebulous concept within orthopaedics and can be defined as a simple economic ratio: healthcare outcomes achieved per dollar spent.

Healthcare expenditures currently account for 18% of the United States Gross Domestic Product (GDP). Some experts have suggested that an emphasis on value may be an effective strategy to evaluate healthcare costs. In a recent article published in the inaugural issue of JBJS Reviews, authors Benedict U. Nwachukwu, MD, MBA; Kamran S. Hamid, MD, MPH; and Kevin J. Bozic, MD, MBA, argue that understanding value necessitates measuring outcome and cost at the patient level, and that the focus should be on results from validated disease-specific patient-reported outcome measures and health-related quality-of-life measures, measured across the continuum of a patient's care cycle.

"As the United States healthcare system shifts from one that rewards and incentives volume and intensity of services delivered to a more value-conscious payment and delivery system, orthopedic surgeons will increasingly need to understand and implement the principles of value-based healthcare, " said Dr. Bozic, orthopedic surgeon, health policy researcher, and senior author of the study. "Our manuscript outlines some of the key principles and strategies that will enable orthopedic surgeons to collaborate with other healthcare stakeholders to improve the value of musculoskeletal care."

Key Findings

  • Value in orthopedic surgery is most effectively defined as health outcomes per dollar spent. A patient-focused definition of value benefits all stakeholders in musculoskeletal care.
  • Value can be measured by understanding patient outcomes (including disease-specific patient-reported outcomes as well as generic health-related quality of life) and the cost of care across the entire continuum of musculoskeletal care.
  • Calculating costs can be challenging. Popular cost-accounting methods in orthopedics include standard cost accounting and job order cost accounting. Time-driven activity-based costing holds great promise as a model to fully capture the cost of care.
  • orthopedic surgeons will need access to efficient tools for measuring and reporting both outcomes and costs in real time in order to use this information in medical decision making.
  • Collaboration across various disciplines both within and outside of orthopedics is essential in order to operationalize valid widespread outcome assessment and transparent cost accounting.

"Medical practice around the world is changing rapidly. Aspects of patient care that historically have been costly in terms of dollars spent and adverse events incurred are coming under much greater scrutiny," explained Thomas A. Einhorn, MD, Editor of JBJS Reviews. "While many have suggested that an emphasis on value may be an effective way to control costs in health care, the value framework is poorly understood. This article clarifies many of these concepts and provides a basis on which orthopedic surgeons and trainees can understand important issues for the future of orthopedic practice as the rapidly changing environment surrounding us continues to take hold."


Story Source:

The above story is based on materials provided by Journal of Bone and Joint Surgery. Note: Materials may be edited for content and length.


Journal Reference:

  1. Benedict U. Nwachukwu, MD, MBA, Kamran S. Hamid, MD, MPH, Kevin J. Bozic, MD, MBA. Measuring Value in Orthopaedic Surgery. JBJS Reviews, November 2013

Cite This Page:

Journal of Bone and Joint Surgery. "Measuring value, impact of orthopedic care." ScienceDaily. ScienceDaily, 26 November 2013. <www.sciencedaily.com/releases/2013/11/131126123933.htm>.
Journal of Bone and Joint Surgery. (2013, November 26). Measuring value, impact of orthopedic care. ScienceDaily. Retrieved July 28, 2014 from www.sciencedaily.com/releases/2013/11/131126123933.htm
Journal of Bone and Joint Surgery. "Measuring value, impact of orthopedic care." ScienceDaily. www.sciencedaily.com/releases/2013/11/131126123933.htm (accessed July 28, 2014).

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