Payback Value Outweighs Treatment Costs

According to a study funded by the AAOS and published in BioMed Central’s open access journal, Cost Effectiveness and Resource Allocation, the value of orthopaedic treatment for musculoskeletal conditions can be far greater than the cost of the treatment.

The methodological model evaluates musculoskeletal-related limitations and infers indirect economic outcomes and the societal value of specific orthopaedic surgery procedures. It provides a foundation to assess the value of procedures and health services, both within and beyond the field of orthopaedics, where primary data are limited.

“From the perspectives of the patient, employers, and society, the ‘value’ of appropriate medical treatment extends beyond current and future medical expenditures,” said John R. Tongue, MD, AAOS president. “It includes things like whether people can maintain their own independence, remain productively employed, avoid payments for disability or long-term care, and have an overall improvement of their quality of life.”

Dr. Tongue pointed out that the new methodology enables researchers to examine musculoskeletal care as it relates to specific conditions. It brings to light societal and economic benefits currently overlooked in the larger healthcare value discussion.

“In an increasingly cost- and quality-conscious healthcare environment, this analysis provides critical insight into what the true value of orthopaedic care means for patients,” he said.

Many studies have quantified the burden of musculoskeletal disorders and the cost-effectiveness of treatment—including several being presented during the 2013 AAOS Annual Meeting. Few studies, however, have looked at the impact of indirect cost measures, such as employability and loss of income, and the value these services provide to workers and their families, employers, and society.

Research model
Data from more than 185,000 people included in the National Health Information Survey (NHIS) were evaluated in the study, which measured the relationship between physical limitations associated with musculoskeletal disorders and indirect indicators of cost, such as employability, missed days of work, household income, and disability income. Using the NHIS findings and data from clinical studies, the researchers created an index that estimated the impact of specific orthopaedic surgery procedures on physical limitations and indirect costs.

Among the findings of the published research are the following:

Physical impairments associated with musculoskeletal disorders reduce household income and the likelihood of employment, and increase missed work days and disability pay for those who are employed.
Appropriate treatment of musculoskeletal disorders has the potential to significantly reduce indirect costs and is associated with net economic benefits to society.

According to Tim Dall, MS, who led the study, the research breaks new ground by quantifying the indirect value of common bone and joint procedures.

“It is important that policymakers and tax payers, as well as affected individuals, are aware of how the costs of surgery balances against loss of employment and the need for long-term assistance in everyday living,” he said. He pointed out that both direct medical costs and the indirect economic impact of treatment and the patient’s quality of life are needed to fully understand the net value of any treatment.

Learn more
The methodology paper is the latest effort by AAOS to highlight the value of high-quality orthopaedic care. Last year AAOS launched the national campaign, A Nation in Motion® (ANationInMotion.org) centered on hundreds of inspiring stories of people at every stage of life whose lives and mobility have been restored because of their orthopaedic care.

The full study, “Modeling the Indirect Economic Implications of Musculoskeletal Disorders and Treatment,” is available at www.resource-allocation.com

Mr. Dall will be among the panelists at Symposium V: The Social and Economic Value of Orthopaedic Surgery, being presented on Friday, March 22, at 8:00 a.m. in Room S406 at McCormick Place. The symposium will be webcast live and available for download at www.aaos.org/annual

AAOS commissioned KNG Health Consulting, LLC (KNG Health) and its partner, IHS Global Inc., to prepare this study.

2013 Annual Meeting News
Tuesday through Friday, February 19 – 23, 2013.
http://www.aaos.org/news/acadnews/2013/AAOS28_3_19.asp