The Effect of Price on Surgeons' Choice of Implants: A Randomized Controlled Survey
| Autor: | James A. Gillespie, Kyle J. Jeray, Constanza L. Moreno-Serrano, Peter J. Evans, Burak Altintas, Ofer Levy, Chad Manke, Raj Karia, Stephen K. Westly, Platz Andreas, Clifford B. Jones, Sergio Rowinski, Robert D. Zura, Neil Wilson, Lars C. Borris, Fabio Suarez, Marinis Pirpiris, Jeffrey Yao, Craig M. Rodner, Anna N. Miller, Efsthathios G. Ballas, Peter L. Althausen, Julie E. Adams, Scott F. M. Duncan, Nata Parnes, Parag Sancheti, Michael W. Grafe, Lars Adolfsson, Thierry G. Guitton, Kevin M. Rumball, Rolf W. Peters, Timothy Omara, Kendrick E. Lee, J. Biert, Eitan Melamed, Julius A. Bishop, Eric P. Hofmeister, Benjamin W. Sears, S.A. Meylaerts, Jorge Rubio, Jose Eduardo Grandi Ribeiro Filho, James F. Nappi, Daniel Rikli, Ryan P. Calfee, Ippokratis Pountos, Edward J. Harvey, Erik T. Walbeehm, P. Lygdas, J. Carel Goslings, Lewis B. Lane, Doug Hanel, F. J. Seibert, Grant J. Bayne, A.B. Arne Berner, Luke S. Austin, Mohamed Shafi, David S. Ruch, Stephen A. Kennedy, Milind Merchant, Leon S. Benson, Ricardo J. Bello, Peter J. L. Jebson, Robin N. Kamal, Jerry I. Huang, Ladislav Mica, Michael Nancollas, Juan Martín Patiño, Michael W. Kessler, John A. Scolaro, Marc F. Swiontkowski, Steve Kronlage, Alexander Marcus, M. Jason Palmer, Lob Guenter, Nikolaos K. Kanakaris, Russell Shatford, Harold Alonso Villamizar, Evan D. Schumer, Radzeli Mohd Ramli, Andrew John Powell, Nicholas L. Shortt, A.J.H. Vochteloo, Francisco Lopez-Gonzalez, Saul Kaplan, Ralph M. Costanzo, Gregory L. DeSilva, Carl Ekholm, Ngozi M. Akabudike, Thomas A. DeCoster, Shep Hurwit, John T. Capo, Karel Chivers, Richard S. Gilbert, Daniel Haverkamp, Marc J. Richard, Rodrigo Pesantez, Giuseppe Porcellini, Peter Krause, Matej Kastelec, Brett D. Crist, Amy S. Wasterlain, Carlos Henrique Fernandes |
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| Přispěvatelé: | Other departments, Surgery, AMS - Ageing & Morbidty, AMS - Restoration & Development |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty External fixator Attitude of Health Personnel Dentistry Choice Behavior Locking plate 03 medical and health sciences 0302 clinical medicine Cost implant price surgeon survey Female Humans Orthopedic Surgeons Practice Patterns Physicians' Prostheses and Implants Surveys and Questionnaires Health Care Costs medicine Orthopedics and Sports Medicine 030212 general & internal medicine Specific model health care economics and organizations 030222 orthopedics Descriptive statistics business.industry Evidence-based medicine Surgery Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] Extremity fractures Orthopedic surgery Implant business |
| Zdroj: | Journal of hand surgery, 42A(8), 593-601.e6. W.B. Saunders Ltd The Journal of Hand Surgery, 42, 8, pp. 593-601.e6 The Journal of Hand Surgery, 42, 593-601.e6 |
| ISSN: | 0363-5023 |
| Popis: | Item does not contain fulltext PURPOSE: Surgical costs are under scrutiny and surgeons are being held increasingly responsible for cost containment. In some instances, implants are the largest component of total procedure cost, yet previous studies reveal that surgeons' knowledge of implant prices is poor. Our study aims to (1) understand drivers behind implant selection and (2) assess whether educating surgeons about implant costs affects implant selection. METHODS: We surveyed 226 orthopedic surgeons across 6 continents. The survey presented 8 clinical cases of upper extremity fractures with history, radiographs, and implant options. Surgeons were randomized to receive either a version with each implant's average selling price ("price-aware" group), or a version without prices ("price-naive" group). Surgeons selected a surgical implant and ranked factors affecting implant choice. Descriptive statistics and univariate, multivariable, and subgroup analyses were performed. RESULTS: For cases offering implants within the same class (eg, volar locking plates), price-awareness reduced implant cost by 9% to 11%. When offered different models of distal radius volar locking plates, 25% of price-naive surgeons selected the most expensive plate compared with only 7% of price-aware surgeons. For cases offering different classes of implants (eg, plate vs external fixator), there was no difference in implant choice between price-aware and price-naive surgeons. Familiarity with the implant was the most common reason for choosing an implant in both groups (35% vs 46%). Price-aware surgeons were more likely to rank cost as a factor (29% vs 21%). CONCLUSIONS: Price awareness significantly influences surgeons' choice of a specific model within the same implant class. Merely including prices with a list of implants leads surgeons to select less expensive implants. This implies that an untapped opportunity exists to reduce surgical expenditures simply by enhancing surgeons' cost awareness. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic/Decision Analyses I. |
| Databáze: | OpenAIRE |
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