Informed decision-making cuts down on surgeries, costs

After suggesting patients use decision aids before undergoing treatment, a large health system in Washington State saw fewer elective surgeries and lower costs for osteoarthritis patients, according to a study in the September Health Affairs.

Thanks to video-based aids that present the pros and cons of treatment options, hip replacement surgeries fell 26 percent and knee replacement surgeries dropped 38 percent, while costs fell between 12 percent and 21 percent over six months, the study found.

The decision aids offer patients unbiased information, such as the three-month recovery time for joint replacement, the 10- to 20-year lifespan of artificial joints and potential risk of infection or reoperation, Group Health Cooperative, a nonprofit health system in Seattle, said yesterday in a research announcement.

The findings bode well as the industry aims to curb excessive care and keep medical costs in check. In fact, hospitals could see major orthopedic care savings with such informed decision-making tools. Knee and hip replacements are among the most common orthopedic procedures, costing a combined $15.6 billion a year, Group Health noted.

However, because decision aids may influence patients to forgo procedures, they may be more welcomed in care models that use a salaried structure, HealthLeaders Media reported.

"But implementing decision aids and shared decision-making can work well in fee-for-service settings too," noted study leader David E. Arterburn, a general internist and associate investigator at Group Health Cooperative's research division. "They just need healthcare providers who are concerned about having their patients make high-quality informed decisions--and most providers are," he said in a statement.

Arterburn also noted that decision aids should not a take the place of conversations between providers and patients, HealthLeaders reported.

To learn more:
- here's the study abstract
- check out the research announcement
- read the HealthLeaders article