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Creating a Value Dashboard for Orthopaedic Surgical Procedures
- Source :
- The Journal of bone and joint surgery. American volume. 102(21)
- Publication Year :
- 2020
-
Abstract
- Background Value-based health-care delivery is a framework for restructuring our health-care systems with the goal of providing better outcomes for patients at lower cost. Value is determined by patient health outcomes per dollar spent on health services. We sought to develop a value dashboard that could be used to easily track and improve the value of total hip and knee arthroplasty (THA and TKA). Methods We created a value dashboard for TKAs and THAs at our institution. Value was defined as quality of outcomes per dollar spent. The dashboard for each procedure displayed the average value by surgeon, compared with institutional averages for physical function scores and cost. Quality metrics were determined by weighted surgeon ranking using a modified Delphi process and included both clinical and patient-reported outcomes, as measured by the mean change in the Patient-Reported Outcomes Measurement Information System Global-10 (PROMIS-10) physical function score, mean change in the Hip disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS-JR) or the Knee injury and Osteoarthritis Outcome Score-Joint Replacement (KOOS-JR), mean change in the modified Single Assessment Numeric Evaluation (SANE) score, complication rate, periprosthetic joint infection (PJI) rate, and 30-day readmission rate. Average direct costs per surgeon were used. Data from January 2017 through April 2018 were included to ensure 1-year follow-up. Results Six surgeons were included in the value dashboard for TKA, and 5 were included in the THA dashboard. The value for TKA by surgeon ranged from 7% below to 12% above the institutional benchmark. The value for THA by surgeon ranged from 12% below to 7% above the institutional benchmark. Conclusions The proposed dashboard utilizes value in a health-care framework and could be used for comparing and improving value for THA and TKA. This dashboard successfully combined patient outcome metrics and direct costs of surgical procedures. Future studies should focus on involving patients in this process and using national data to create benchmarks, which could provide a more accurate representation of value than using institutional averages.
- Subjects :
- musculoskeletal diseases
Male
medicine.medical_specialty
Quality Assurance, Health Care
medicine.medical_treatment
Arthroplasty, Replacement, Hip
Dashboard (business)
MEDLINE
Periprosthetic
Patient Readmission
Indirect costs
Health care
Medicine
Humans
Orthopedics and Sports Medicine
Patient Reported Outcome Measures
Arthroplasty, Replacement, Knee
Aged
Quality Indicators, Health Care
Quality of Health Care
business.industry
General Medicine
Middle Aged
Arthroplasty
surgical procedures, operative
Value (economics)
Physical therapy
Surgery
Female
business
Quality assurance
Subjects
Details
- ISSN :
- 15351386
- Volume :
- 102
- Issue :
- 21
- Database :
- OpenAIRE
- Journal :
- The Journal of bone and joint surgery. American volume
- Accession number :
- edsair.doi.dedup.....21ff18b4ee1d2b1fecc18760007708cc