Decision aids may reduce rates and cost for some elective surgeries

The use of decision aids may reduce rates of elective surgery and lower costs for elective surgeries including knee and hip osteoarthritis, according to a study by the Commonwealth Fund.

For the study, researchers looked at changes in surgical rates and costs over six months following the start of a program to introduce decision aids for hip and knee osteoarthritis. The decision aids included evidence-based information about the risks and benefits of the procedures. 

Key Findings

  • After adjusting for age, severity of condition, and other factors, the rate of hip replacement surgery was 26 percent lower among patients who received decision aids. Patients who had hip replacement surgery were more likely to be older, to have had at least one appointment related to hip osteoarthritis in the past year, and to have had at least one prior large-joint injection.
  • The rate of knee replacement surgeries was 38 percent lower among patients who received decision aids. Patients who had knee replacement surgery were more likely to be older and to have had prior appointments related to knee osteoarthritis in the past year, and less likely to have had knee X-ray or knee magnetic resonance imaging in the prior year.
  • Costs were lower for patients with knee and hip osteoarthritis after decision aids were introduced. Among patients with hip osteoarthritis, costs were 21 percent lower. Costs for patients with knee osteoarthritis after decision aids were introduced were 12 percent lower.

The authors conclude that decision aids may reduce rates of elective surgery and lower costs, particularly when they are used for conditions in which treatment decisions are highly sensitive to both patients’ and physicians' preferences.

(Source: The Commonwealth Fund, http://www.commonwealthfund.org/, September 5, 2012)