How Much Do Patients Value Total Hip and Knee Arthroplasty? A Prospective, Multicenter Study

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• 作者：P. Maxwell Courtney ; MD^a ; ; Mark Howard ; BS^a ; Nitin Goyal ; MD^b ; Ran Schwarzkopf ; MD ; MSc^c ; Erik Schnaser ; MD^d ; Neil P. Sheth ; MD^a
• 关键词：total hip arthroplasty ; total knee arthroplasty ; reimbursement ; health policy
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：31
• 期：3
• 页码：562-566.e3
• 全文大小：1904 K

文摘

With increasing health care expenditures, reform has largely focused on cost containment, particularly in elective procedures such as total hip and knee arthroplasty (THA and TKA, respectively). The primary objective of this study is to determine what financial value patients place on these highly successful procedures.

Methods

An anonymous survey was administered to 670 patients at 4 different institutions (2 private practice and 2 academic centers) in the outpatient setting over a 15-month period. Patients were asked what reimbursement a surgeon should receive for a primary total joint arthroplasty (TJA), their perception of how much Medicare actually reimburses for TJA, how much they would pay out of pocket for the procedure, and their opinion of current Medicare reimbursement rates.

Results

Of the 557 patients who participated in the survey (83% response rate), patients on average felt that orthopedic surgeons should be reimbursed $27,430 for a THA and $19,830 for a TKA. Patients would be willing to pay a significant amount of out-of-pocket costs for their procedure, mean of $14,397 for THA (50.3% of total costs) and $12,797 for TKA (46.3% of total costs). Although patients in private practice groups had higher education and household income (P < .001), patients in academic centers would be willing to pay more out-of-pocket costs ($15,922 vs $5782, P = .034 for THA, $14,419 vs $4556, P = .052 for TKA).

Conclusion

Patients in both private practice and academic centers feel that surgeons are underpaid for primary THA and TKA. As controversy continues to surround orthopedic surgeons' participation in Medicare, many patients are still willing to pay a significant amount of out-of-pocket expenses for TJA.