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Measuring Patient Value after Total Shoulder Arthroplasty

Evaluating the value of health care is of paramount importance to keep improving patients’ quality of life and optimizing associated costs. Our objective was to present a calculation method based on Michael Porter’s formula and standard references to estimate patient value delivered by total shoulde...

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Autores principales: Lädermann, Alexandre, Eurin, Rodolphe, Alibert, Axelle, Bensouda, Mehdi, Bothorel, Hugo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658226/
https://www.ncbi.nlm.nih.gov/pubmed/34884402
http://dx.doi.org/10.3390/jcm10235700
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author Lädermann, Alexandre
Eurin, Rodolphe
Alibert, Axelle
Bensouda, Mehdi
Bothorel, Hugo
author_facet Lädermann, Alexandre
Eurin, Rodolphe
Alibert, Axelle
Bensouda, Mehdi
Bothorel, Hugo
author_sort Lädermann, Alexandre
collection PubMed
description Evaluating the value of health care is of paramount importance to keep improving patients’ quality of life and optimizing associated costs. Our objective was to present a calculation method based on Michael Porter’s formula and standard references to estimate patient value delivered by total shoulder arthroplasty (TSA). We retrospectively reviewed the records of 116 consecutive TSAs performed between June 2015 and June 2019. Patient value was defined as quality of care divided by direct costs of surgery. Quality metrics included intra- and postoperative complications as well as weighted improvements in three different patient-reported outcome measures at a minimum of one-year follow-up. Direct costs of surgery were retrieved from the management accounting analyses. Substantial clinical benefit (SCB) thresholds and the standard reimbursement system were used as references for quality and cost dimensions. A multivariable linear regression was performed to identify factors associated with patient delivered value. Compared to a reference of 1.0, the quality of care delivered to patients was 1.3 ± 0.3 (range, 0.6–2.0) and the associated direct cost was 1.0 ± 0.2 (range, 0.7–1.6). Ninety patients (78%) had a quality of care ≥1.0 and 61 patients (53%) had direct costs related to surgery ≤1.0. The average value delivered to patients was 1.3 ± 0.4 (range, 0.5–2.5) with 91 patients (78%) ≥ 1.0, was higher for non-smokers (beta, 0.12; p = 0.044), anatomic TSA (beta, 0.53; p < 0.001), increased with higher pre-operative pain (beta, 0.08; p < 0.001) and lower pre-operative Constant score (beta, −0.06; p = 0.001). Our results revealed that almost 80% of TSAs provided substantial patient value. Patient pre-operative pain/function, tobacco use, and procedure type are important factors associated with delivered patient value.
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spelling pubmed-86582262021-12-10 Measuring Patient Value after Total Shoulder Arthroplasty Lädermann, Alexandre Eurin, Rodolphe Alibert, Axelle Bensouda, Mehdi Bothorel, Hugo J Clin Med Article Evaluating the value of health care is of paramount importance to keep improving patients’ quality of life and optimizing associated costs. Our objective was to present a calculation method based on Michael Porter’s formula and standard references to estimate patient value delivered by total shoulder arthroplasty (TSA). We retrospectively reviewed the records of 116 consecutive TSAs performed between June 2015 and June 2019. Patient value was defined as quality of care divided by direct costs of surgery. Quality metrics included intra- and postoperative complications as well as weighted improvements in three different patient-reported outcome measures at a minimum of one-year follow-up. Direct costs of surgery were retrieved from the management accounting analyses. Substantial clinical benefit (SCB) thresholds and the standard reimbursement system were used as references for quality and cost dimensions. A multivariable linear regression was performed to identify factors associated with patient delivered value. Compared to a reference of 1.0, the quality of care delivered to patients was 1.3 ± 0.3 (range, 0.6–2.0) and the associated direct cost was 1.0 ± 0.2 (range, 0.7–1.6). Ninety patients (78%) had a quality of care ≥1.0 and 61 patients (53%) had direct costs related to surgery ≤1.0. The average value delivered to patients was 1.3 ± 0.4 (range, 0.5–2.5) with 91 patients (78%) ≥ 1.0, was higher for non-smokers (beta, 0.12; p = 0.044), anatomic TSA (beta, 0.53; p < 0.001), increased with higher pre-operative pain (beta, 0.08; p < 0.001) and lower pre-operative Constant score (beta, −0.06; p = 0.001). Our results revealed that almost 80% of TSAs provided substantial patient value. Patient pre-operative pain/function, tobacco use, and procedure type are important factors associated with delivered patient value. MDPI 2021-12-04 /pmc/articles/PMC8658226/ /pubmed/34884402 http://dx.doi.org/10.3390/jcm10235700 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lädermann, Alexandre
Eurin, Rodolphe
Alibert, Axelle
Bensouda, Mehdi
Bothorel, Hugo
Measuring Patient Value after Total Shoulder Arthroplasty
title Measuring Patient Value after Total Shoulder Arthroplasty
title_full Measuring Patient Value after Total Shoulder Arthroplasty
title_fullStr Measuring Patient Value after Total Shoulder Arthroplasty
title_full_unstemmed Measuring Patient Value after Total Shoulder Arthroplasty
title_short Measuring Patient Value after Total Shoulder Arthroplasty
title_sort measuring patient value after total shoulder arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658226/
https://www.ncbi.nlm.nih.gov/pubmed/34884402
http://dx.doi.org/10.3390/jcm10235700
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