Evidence map›Paper›PMID 33902580›Full record

ArticleBMC health services research2021

The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery.

Fanny Goude, Sverre A C Kittelsen, Henrik Malchau, Maziar Mohaddes, Clas Rehnberg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Fanny GoudeDepartment of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 17177, Stockholm, Sweden. fanny.goude@ki.se.
Sverre A C KittelsenFrisch Centre, Gaustadalléen 21, 0349, Oslo, Norway.
Henrik MalchauDepartment of Orthopaedics, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Maziar MohaddesDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg university, Medicinaregatan 3, 41390, Göteborg, Sweden.
Clas RehnbergDepartment of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 17177, Stockholm, Sweden.
Karolinska Institutet · SEMassachusetts General Hospital · USThe Swedish Hip Arthroplasty Register · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCompetition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery.

methodsUsing patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects.

resultsThe entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust.

conclusionsCompetition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

Indexed as

Arthroplasty, Replacement, HipHumansPain MeasurementPatient Reported Outcome MeasuresSwedenTreatment OutcomeVisual Analog ScaleBundled paymentCompetitionDifference-in-difference analysisEconomic incentivesEntropy balancingPatient choicePatient reported outcome measuresPropensity scoresQualityTotal hip replacement

Identifiers

PMID33902580
PMCPMC8077897
OpenAlexW3159240062

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.