"As efforts continue to define value in healthcare, it is critical to include the patient perspective, as well as clinical data such as complications and readmissions."
Dear Editor,
The pressure to move healthcare from volume to value is ever increasing. ("Plans for Medicare Payment Overhaul Receive Mixed Reviews", January 28). We know we are all going to get there eventually, but will it be for the sake of the bottom line or the sake of the patient?
As efforts continue to define value in healthcare, it is critical to include the patient perspective, as well as clinical data such as complications and readmissions.
We at FORCE-TJR Quality Improvement have spent the last four years capturing patient reported outcome measures (PROs) from 30,000 total joint replacement patients across the U.S. We've found that data based on patient self-reported pain, functional limitation and quality of life is not only valid, measurable and consistent, it can guide efficient and effective patient care.
Value in healthcare should be defined as the ratio of the benefits that accrue to patients from treatment received to the dollars spent providing that treatment; PROs have a critical role in determining those benefits. The U.K. is using PROs to do just that for their top four high-volume, high-cost conditions, including total joint replacements.
Measuring improvement in patient-reported health and quality of life to determine if the cost of care is worth it seems a good place for the U.S. to start.
David C. Ayers MD
Chair, Department of Orthopaedics and Rehabilitation
University of Massachusetts Medical School
ayersd@ummhc.org
Patricia D. Franklin MD MBA MPH
Professor and Director, Department of Orthopedics and Rehabilitation
University of Massachusetts Medical School
patricia.franklin@umassmed.edu
FORCE-TJR is a nationwide, comprehensive database of total joint replacement surgical and patient-reported outcomes developed by the University of Massachusetts Department of Orthopedics and Physical Rehabilitation.