Study finds sizeable underutilization of hip and knee replacement procedures

vertising, so that people better understand the benefits and be less fearful about the process. This would lead to increased acceptance of these kinds of surgical procedures."

Researchers also found substantial disparities in utilization across race and gender lines, but were unable to pinpoint the root causes. For example, African Americans and Hispanics have no less need for hip or knee replacements than whites, but they choose them less often.

Further, women are more likely than men to have osteoarthritis of the hip, but do not undergo replacements until an advanced state of disability, which results in a longer rehabilitation and poorer outcome.

According to George, the Duke team was surprised to find how little had been done to study outcomes and the timeframes in which patients were monitored. Range of motion and pain reduction were checked in the hospital or a rehabilitation facility in the days or weeks immediately after a surgery, but not beyond.

"When you're talking about an older population, you're not looking for a return to work, necessarily, but people who can now or continue to take care of themselves and do their own shopping or housework may not need assisted living or nursing home services," said George. "Most data are limited to studies in one or two medical centers and does not reflect the kind of monitoring that is the norm in the average community hospital. We will be analyzing data from thousands of people from all across the country to make better estimates of levels of disability and impacts on quality of life resulting from joint replacements."

Team to study long-term effects on "human capital"

The on-going Duke study will use data drawn from the Center for Medicare and Medicaid Services and the National Long Term Care Survey to explore the effects of medical technology innovations such as knee and hip replacements on human capital the economic savings in terms of productive activiti

Contact: Michael Stewart
InHealth: The Institute for Health Technology Studies

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