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Utilization of orthopaedic services in a capitated population
Mark R Brinker1, Daniel P O'Connor, Peggy Pierce
1Center for Musculoskeletal Research and Outcomes Studies, Fondren Orthopedic Group L.L.P., 7401 South Main Street, Houston, TX 77030, USA.
The Journal of Bone and Joint Surgery. American Volume
|November 14, 2002
Summary
Orthopaedic service utilization rates were determined for a capitated population. Older age was linked to higher office visit and surgical procedure rates, with no significant gender differences.
Area of Science:
- Orthopaedic Surgery
- Health Services Research
- Epidemiology
Background:
- The utilization rates of orthopaedic services, including office visits and surgical procedures, are not well-established.
- Understanding these rates is crucial for healthcare planning and resource allocation.
Purpose of the Study:
- To determine the utilization rates for orthopaedic office visits and surgical procedures within a large, capitated population.
- To identify the primary drivers of orthopaedic service utilization.
Main Methods:
- A prospective study was conducted on an average of 134,902 individuals per month enrolled in a capitated insurance plan from January to December 1999.
- Data were collected and stored in a centralized database, with analyses based on monthly averages.
- Poisson regression was employed to compare utilization rates and assess the influence of age and gender.
Main Results:
- The leading causes for office visits included fractures (21%), osteoarthritis (4%), meniscal tears (4%), and low-back pain/sciatica (4%).
- Knee arthroscopy (30%), foot and ankle procedures (10%), and spine procedures (9%) were the most common surgical interventions.
- Overall utilization rates were 6.96 office visits and 1.99 surgical procedures per 1000 covered lives per month. Increased age correlated significantly with higher utilization for both office visits and surgeries, while gender showed no significant difference.
Conclusions:
- The findings provide valuable data for determining the capacity of orthopaedic practices serving capitated populations.
- These utilization rates can inform staffing needs and financial projections for orthopaedic services in capitated models.
- The study highlights the impact of age on orthopaedic service demand within a managed care setting.