Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-06-03T09:13:06.051Z Has data issue: false hasContentIssue false

Social and Health Policy Issues in Total Joint Replacement Surgery

Published online by Cambridge University Press:  10 March 2009

Matthew H. Liang
Affiliation:
Harvard Medical School
John Wade
Affiliation:
Brigham and Women's Hospital
Robert M. Hartley
Affiliation:
Bain and Company, Boston, MA
Karen E. Cullen
Affiliation:
Ledgeway Group, Lexington, MA
Arthur L. Caplan
Affiliation:
University of Minnesota

Abstract

Total joint replacement has restored function and provided comfort to many patients who would otherwise have suffered. However, success and widespread diffusion of this procedure pose a number of important questions. The patient's and the doctor's criteria of success may not be the same: Which are to be used? Health resources are becoming limited: Should money be spent to restore function and for pain relief to those late in life or past their work life? Who makes this choice? A medical technology is tested in the best of settings but routinely practiced in many: How should society and health care professionals monitor the results of surgery? Who should do surgery and where should it be done?

Type
Special Section: The Organization and Use of Technology in the Hospital Part II: Case Studies
Copyright
Copyright © Cambridge University Press 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Anderson, G.Hip assessment: A comparison of nine different methods. Journal of Bone Joint Surgery, 1982, 54B, 621625.Google Scholar
2.Brinkley, J.Key hospital accrediting agency to start weighing mortality rates.” New York Times, 11 4, 1986, 1 and 26.Google Scholar
3.Burton, K. E., Wright, V., & Richards, J.Patients' expectations in relation to outcome of total hip replacement surgery. Annals of the Rheumatic Diseases, 1979, 38, 471474.CrossRefGoogle Scholar
4.Caplan, A. L. How should values count in the allocation of new technologies in health care? In Bayer, R., Caplan, A. L., & Daniels, N. (eds.), In search of equity: Health needs and the health care system. Hastings Center Series in Ethics. New York: Plenum, 1983, 95124.CrossRefGoogle Scholar
5.Fuchs, V. R.Who shall live? Health economics and social choice. New York: Basic Books, 1974.Google Scholar
6.Galante, J. O.The need for a standardized system for evaluating results of total hip surgery. Journal of Bone Joint Surgery, 1985, 67A, 511512.CrossRefGoogle ScholarPubMed
7.Hori, R. Y., Lewis, J. L., Zimmerman, J. R., & Compere, C. L.The number of joint replacements in the United States. Clinical Orthopedics and Related Research, 1976, 132, 4652.Google Scholar
8.Kelsey, J. L. Epidemiology and Impact. In National Institutes of Health, Consensus development conference: Total hip and joint replacement program, Bethesda: NIH, 1982, 2330.Google Scholar
9.Liang, M. H., Cullen, K. E., Larson, M. G., Thompson, M. S., Schwartz, J. A., Fossel, A. H., Roberts, N. H., & Sledge, C. B.Cost-effectiveness of total joint arthroplasty in osteoarthritis. Arthritis and Rheumatism, 1986, 28, 542547.CrossRefGoogle Scholar
10.Liang, M. H., Cullen, K. E., & Poss, R.Primary total hip or knee replacement: Evaluation of patients. Annals of Internal Medicine, 1982, 97, 735739.CrossRefGoogle ScholarPubMed
11.Liang, M. H., Larson, M. G., Cullen, K. E., & Schwartz, J. A.Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. Arthritis and Rheumatism, 1985, 28, 542547.CrossRefGoogle ScholarPubMed
12.Lubitz, J., Riley, G., & Newton, M.Outcomes of surgery among the Medicare aged: Mortality after surgery. Health Care Financing Review, 1985, 6, 103114.Google ScholarPubMed
13.Luft, H. S., Bunker, J. P., & Enthoven, A. C.Should operations be regionalized: The empirical relation between surgical volume and mortality. New England Journal of Medicine, 1979, 301, 13641369.CrossRefGoogle ScholarPubMed
14.Maynard, C., Fisher, L. D., Passamani, E. R., & Pullum, T.Blacks in the coronary artery surgery study (CASS): Race and clinical decision making. American Journal of Public Health, 1986, 76, 14461448.CrossRefGoogle ScholarPubMed
15.Melton, L. J., Stauffer, R. N., Chao, E. Y. S., & Ilstrup, D. M.Rates of total hip arthroplasty: A population based study. New England Journal of Medicine, 1982, 307, 12421245.CrossRefGoogle ScholarPubMed
16.Nelson, J. P., Grassburn, A. R. Jr, Talbott, R. D., & McElhinney, J. P.The effect of previous surgery, operating room environment and preventive antibiotics on postoperative infection following total hip arthroplasty. Clinical Orthopedics and Related Research, 1980, 147, 167169.CrossRefGoogle Scholar
17.Rogers, M. P., Liang, M. H., Poss, R., & Cullen, K.Adverse psychological sequelae associated with total joint replacement surgery. General Hospital Psychiatry, 1982, 4, 155158.CrossRefGoogle ScholarPubMed
18.The American College of Surgeons and the American Surgical Association. Surgery in the United States: A summary report of the study on surgical services for the United States. Chicago: 1976, 11150.Google Scholar
19.Visuri, T., & Honkanen, R.The influence of total hip replacement on selected activities of daily living and on the use of domestic aid. Scandinavian Journal of Rehabilitation Medicine, 1978, 10, 221225.Google ScholarPubMed
20.Wilcock, G. K.Benefits of total hip replacement to older patients and the community. British Medical Journal, 1978, 2, 3739.CrossRefGoogle ScholarPubMed