Factors that influence provider selection for elective total joint arthroplasty.

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Patient-Centered Care

Background:

• Growing consumer-directed health plans increase demand for healthcare cost and quality data.
• Understanding patient decision-making for elective orthopaedic procedures like total joint arthroplasty (TJA) is crucial.
• Factors influencing provider choice for TJA are not well understood.

Purpose of the Study:

• To identify key factors patients consider when selecting an orthopaedic surgeon and hospital for TJA.
• To assess the importance patients place on various clinical and nonclinical aspects of care.

Main Methods:

• A survey of 251 patients undergoing primary TJA was conducted.
• Patients rated 37 items across seven dimensions of care on a 5-point Likert scale.
• The study included patients from both academic and community-based orthopaedic practices.

Main Results:

• Physician manner (average Likert, 4.7) and physician quality/outcomes (average Likert, 4.6) were rated as most important.
• A significant gap exists in patients' ability to find comparative outcome data (46% for surgeons, 47% for hospitals).
• Cost sharing was identified as the least important selection criterion.

Conclusions:

• Physician manner and surgical outcomes are paramount for patients choosing TJA providers.
• Patients desire quality information but face barriers in accessing actionable data.
• Development of objective, interpretable, risk-adjusted quality measures is recommended for TJA providers.