After introducing video-based decision aids for people with knee and hip osteoarthritis, Group Health Cooperative saw a significant drop in rates of elective knee and hip replacement surgeries, as well as a drop in the cost of care. According to an article in the September issue of Health Affairs, Group Health found that introducing these decision aids resulted in a 38 percent reduction in knee replacement surgeries, a 26 percent reduction in hip replacement surgeries and a 12 percent decline in health care costs over a six month period.
The observational study, conducted by Dr. David Arterburn, general internist and associate investigator at Group Health Research Institute, and his colleagues, is the first study to examine the impact of decision aids on health care costs and elective surgery in routine medical care. It is also the first major study on hip and knee osteoarthritis decision aids. Group Health used two of the Informed Medical Decisions Foundation’s Shared Decision-Making® programs for this study: “Treatment Choices for Knee Osteoarthritis” and “Treatment Choices for Hip Osteoarthritis.”
With more than 27 million Americans battling osteoarthritis, joint replacement surgeries are among the most common procedures in orthopedics — which makes the findings of this study even more important. These procedures are very expensive, with a combined cost of $15.6 billion a year for knee and hip replacement surgeries. As with many preference-sensitive conditions, surgery is not the only option; there are a number of nonsurgical options that may help relieve the symptoms of arthritis. Decision aids provide patients with unbiased, evidence-based information about the available options so the patient is better equipped to make an informed decision that is aligned with their preferences.
“We have long made the case that making sure patients are informed, by giving them high-quality decision aids is the ethical way to practice medicine,” says Jack Fowler, Foundation senior scientific advisor. “[This study] is the best demonstration that providing decision aids is both a way to improve the quality of medical care and a way to potentially reduce the costs of [care].”
David Arterburn, a medical editor for the Informed Medical Decisions Foundation, received funding from the Foundation for this study.