wow-inequalities/02-data/intermediate/wos_sample/3b7125c4377affbf2f1a1c64f481a872-mota-ruben-e.-mujic/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background: Documented age, gender, race and socio-economic disparities
in total joint arthroplasty (TJA), suggest that those who need the
surgery may not receive it, and present a challenge to explain the
causes of unmet need. It is not clear whether doctors limit treatment
opportunities to patients, nor is it known the effect that patient
beliefs and expectations about the operation, including their paid work
status and retirement plans, have on the decision to undergo TJA.
Identifying socio-economic and other determinants of demand would inform
the design of effective and efficient health policy. This review was
conducted to identify the factors that lead patients in need to undergo
TJA.
Methods: An electronic search of the Embase and Medline (Ovid)
bibliographic databases conducted in September 2011 identified studies
in the English language that reported on factors driving patients in
need of hip or knee replacement to undergo surgery. The review included
reports of elective surgery rates in eligible patients or, controlling
for disease severity, in general subjects, and stated clinical experts''
and patients'' opinions on suitability for or willingness to undergo TJA.
Quantitative and qualitative studies were reviewed, but quantitative
studies involving fewer than 20 subjects were excluded. The quality of
individual studies was assessed on the basis of study design (i.e.,
prospective versus retrospective), reporting of attrition, adjustment
for and report of confounding effects, and reported measures of need
(self-reported versus doctor-assessed). Reported estimates of effect on
the probability of surgery from analyses adjusting for confounders were
summarised in narrative form and synthesised in odds ratio (OR) forest
plots for individual determinants.
Results: The review included 26 quantitative studies-23 on individuals''
decisions or views on having the operation and three about health
professionals'' opinions-and 10 qualitative studies. Ethnic and racial
disparities in TJA use are associated with socio-economic access factors
and expectations about the process and outcomes of surgery. In the
United States, health insurance coverage affects demand, including that
from the Medicare population, for whom having supplemental Medicaid
coverage increases the likelihood of undergoing TJA. Patients with
post-secondary education are more likely to demand hip or knee surgery
than those without it (range of OR 0.87-2.38). Women are as willing to
undergo surgery as men, but they are less likely to be offered surgery
by specialists than men with the same need. There is considerable
variation in patient demand with age, with distinct patterns for hip and
knee. Paid employment appears to increase the chances of undergoing
surgery, but no study was found that investigated the relationship
between retirement plans and demand for TJA. There is evidence of
substantial geographical variation in access to joint replacement within
the territory covered by a public national health system, which is
unlikely to be explained by differences in preference or unmeasured need
alone. The literature tends to focus on associations, rather than
testing of causal relationships, and is insufficient to assess the
relative importance of determinants.
Conclusions: Patients'' use of hip and knee replacement is a function of
their socio-economic circumstances, which reinforce disparities by
gender and race originating in the doctor-patient interaction.
Willingness to undergo surgery declines steeply after the age of
retirement, at the time some eligible patients may lower their
expectations of health status achievement. There is some evidence that
paid employment independently increases the likelihood of operation. The
relative contribution of variations in surgical decision making to
differential access across regions within countries deserves further
research that controls for clinical need and patient lifestyle
preferences, including retirement decisions. Evidence on this question
will become increasingly relevant for service planning and policy design
in societies with ageing populations.'
affiliation: 'Mota, REM (Corresponding Author), Univ Exeter, Inst Hlth Serv Res, Veysey
Bldg,Salmon Pool Lane, Exeter EX2 4SG, Devon, England.
Mota, Ruben E. Mujica, Univ Exeter, Inst Hlth Serv Res, Exeter EX2 4SG, Devon, England.
Tarricone, Rosanna; Ciani, Oriana, Univ Bocconi, Ctr Res Healthcare Management,
I-20136 Milan, Italy.
Bridges, John F. P., Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205
USA.
Drummond, Mike, Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England.'
article-number: '225'
author: Mota, Ruben E. Mujica and Tarricone, Rosanna and Ciani, Oriana and Bridges,
John F. P. and Drummond, Mike
author-email: r.e.mujica-mota@exeter.ac.uk
author_list:
- family: Mota
given: Ruben E. Mujica
- family: Tarricone
given: Rosanna
- family: Ciani
given: Oriana
- family: Bridges
given: John F. P.
- family: Drummond
given: Mike
da: '2023-09-28'
doi: 10.1186/1472-6963-12-225
eissn: 1472-6963
files: []
journal: BMC HEALTH SERVICES RESEARCH
keywords: 'Orthopaedic implant; Arthroplasty; Hip; Knee; Demand; Need; Equity;
Preferences; Patient selection; Osteoarthritis; Decision to operate;
Socio-economic disparities; Total joint replacement'
keywords-plus: 'QUALITY-OF-LIFE; JOINT REPLACEMENT SURGERY; WILLINGNESS-TO-PAY; AGED
55
YEARS; DECISION-MAKING; ORTHOPEDIC SURGEONS; PATIENT PREFERENCES;
PRIMARY-CARE; POPULATION REQUIREMENT; SOCIOECONOMIC-STATUS'
language: English
month: JUL 30
number-of-cited-references: '109'
orcid-numbers: 'Ciani, Oriana/0000-0002-3607-0508
Mujica-Mota, Ruben/0000-0002-7430-2744
TARRICONE, ROSANNA/0000-0002-2009-9357'
papis_id: b783b371f4d2e82b7092127ebf1b9828
ref: Mota2012determinantsdemand
researcherid-numbers: 'Ciani, Oriana/D-1455-2015
'
tags:
- review
times-cited: '95'
title: 'Determinants of demand for total hip and knee arthroplasty: a systematic literature
review'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000310348400001
usage-count-last-180-days: '2'
usage-count-since-2013: '48'
volume: '12'
web-of-science-categories: Health Care Sciences \& Services
year: '2012'