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.
Arterburn D, Wellman R, Westbrook E, et al. Introducing decision aids at Group Health was linked to sharply lower hip and knee surgery rates and costs. Health Aff. 2012 Sept 4;(9):2094-104.
Posted in Cost, Decision Aid Effectiveness, Patient Decision Aids, SDM Implementation
Tagged arthritis, David Arterburn, decision aids, Group Health, Health Affairs, health care cost, hip osteoarthritis, informed decisions, knee osteoarthritis, surgery
With any surgery, consent must be obtained from each patient, and valid consent is based on knowledge of the options, the risks and benefits of each option, and the likelihood that these will occur for the individual patients. The legal doctrine and requirements of informed consent are well known. In theory, informed consent is a process, not a moment in time. In reality, it has occurred when a clinician requests a signature from a patient to authorize that a specific treatment or procedure take place, and the patient signs. In current practice, there is no requirement that shared decision-making occur before the signing of the consent form.
Posted in Patient Decision Aids, Patient Involvement, Patient Preferences, SDM Implementation
Tagged consent form, Dartmouth-Hitchcock Medical Center, decision aids, decision making, informed consent, informed decisions, informed patient choice, Medicare, patient-centered care, patients, shared decision making, surgery
Dr. David Arterburn, lead author of the Health Affairs study and a researcher at Group Health Research Institute in Seattle, calls the procedure "preference-sensitive" because the choice to have one isn't made solely on objective measures. That's where decision aids come in. The goal, he said, is 'to make sure that patients understand that there is more than one option when it comes to osteoarthritis treatment.
The decision aids referenced in this article were developed by the Informed Medical Decisions Foundation.
Read the full-text article.
Tagged arthritis, David Arterburn, decision aids, Group Health, Health Affairs, health care cost, hip osteoarthritis, informed decisions, knee osteoarthritis, surgery, The Boston Globe