“Decision Aids” Cut Joint Replacement Costs

After it introduced a series of video-based “decision aids” for people with knee and hip osteoarthritis, Group Health Cooperative, a consumer-based health care system in Spokane, Washington, saw a significant drop in the number of knee and hip replacement surgeries performed, as well as a drop in the cost of care.

As reported in the September issue of Health Affairs, Group Health found that when the decision aids were presented to potential patients, there was a 38% reduction in knee replacement surgeries, a 26% reduction in hip replacement surgeries and a 12% decline in health care costs over a six month period.

David Arterburn, M.D., associate investigator at Group Health Research Institute, who conducted the study, believed to be the first to examine the impact of decision aids on health care costs and elective surgery. It is also the first major study on hip and knee osteoarthritis decision aids.

“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, ” said Floyd “Jack” Fowler, senior scientific advisor at the Informed Medical Decisions Foundation. “[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].”

More than 27 million Americans deal with osteoarthritis making joint replacement surgeries among the most common of orthopedic procedures. Annual costs for hip and knee replacement surgeries are estimated at $15.6 billion a year.