Today’s Top Story

Study: How Have Hospital Mergers Affected Quality of Care?

According to a study published online in The New England Journal of Medicine, hospital mergers and acquisitions adversely impacted patient experiences but did not significantly affect readmission or mortality rates. Medicare claims and Hospital Compare data spanning 2007 through 2016 were evaluated for four quality care measures: a composite of clinical-process measures, a composite of patient-experience measures, mortality, and the rate of readmission after discharge. Hospital merger and acquisition data from 2009 through 2013 were also assessed; performances were compared for acquired hospitals (n = 246) versus a control group of hospitals that did not change ownership (n = 1,986). Acquired hospitals, compared to controls, presented a modest decline in performance regarding patient-experience measures, but no significant change was observed in 30-day readmission rates or mortality. Outcomes regarding clinical-process measures were inconclusive.

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In Other News

Study: Effectiveness of Communicating Hip-specific PROs via Mobile Phone

A study published in the Jan. 1 issue of the Journal of the AAOS validated the administration of hip-specific patient-reported outcome (PRO) instruments over a mobile phone as opposed to paper or computer. A total of 69 consecutive hip preservation clinic patients responded to the Hip Disability and Osteoarthritis Outcome Score Short Form physical function (HOOS-PS) and pain (HOOS-PAIN) subscales through standard techniques; the next day, they completed the same instruments through text message. They received text message reminders to respond to incomplete questions. For HOOS-PS, the intraclass correlation coefficient between in-clinic and mobile phone delivery was 0.72, and for HOOS-PAIN was 0.80. Nearly all patients (n = 64, 93 percent) completed the questionnaires through mobile phone and software messaging. Nine patients finished the PRO questions after they were reminded via text message. Just more than half of patients (51 percent) filled out the PRO questions within five minutes, 26 percent needed between five and 10 minutes, and 16 percent required 10 to 30 minutes.

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Study Analyzes Malnutrition as a Predictor of Ankle Surgery Outcomes

A retrospective study published online in Foot & Ankle International evaluated the relationship between malnutrition, determined by albumin levels, and 30-day postoperative outcomes in operative ankle fracture treatment. The researchers queried the American College of Surgeons National Surgical Quality Improvement Program database for operative ankle fracture patients for whom baseline serum albumin level information was available. Additional data included baseline patient information, 30-day postoperative complications, readmission, reoperation, and length of stay (LOS). Final analysis included 6,138 patients; mean albumin level was 3.86 g/dL. About 20 percent of patients (n = 1,246, 20.3 percent) were hypoalbuminemic. Patients with an albumin level lower than 3.5 g/dL had a greater risk for complications and readmissions. Hypoalbuminemia was also associated with a significantly longer LOS (4.5 days versus 2.1 days).

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Study: Use of a Radar Gun During Rehab for Baseball Pitchers After Ulnar Collateral Ligament Reconstruction

A simulation study published online in the Journal of Shoulder and Elbow Surgery observed that inclusion of a radar gun during throwing rehabilitation for baseball pitchers after ulnar collateral ligament reconstruction may help protect the reconstructed elbow from excess medial torque. The study included 37 healthy high school and collegiate baseball players who threw five pitches at 50 percent, 75 percent, and 100 percent subjective effort. They then threw five pitches at 50 percent and 75 percent maximum velocity, measured by a radar gun. The 50 percent and 75 percent partial effort pitches were much faster and produced much higher elbow torque compared to the 50 percent and 75 percent velocity pitches, respectively. A 10 percent decrease in maximum velocity percentage was correlated with a 13 percent decrease in maximum elbow torque percentage

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Bundled Payments Reduce Joint Replacement Costs Without Affecting Quality

According to a new study published in the January issue of Health Affairs, Medicare’s voluntary Bundled Payments for Care Improvement (BPCI) initiative was associated with a 1.6 percent decrease in costs for lower-extremity joint replacement but did not reduce quality. Another study, also published in the January issue of Health Affairs, found that the BPCI initiative did not reduce costs for other conditions or procedures.

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Read the abstract…

Read the abstract…


2020 Annual Meeting in Orlando: Discovery, Diverse Educational Opportunities … and Disney

Change is happening in the Academy. The Board-approved strategic plan requires a new level of focus on metrics and objectives needed to achieve our three strategic goals. Aspects of each of the goals will be actualized at the upcoming AAOS 2020 Annual Meeting in Orlando from March 24–28. The goals are: deliver a personalized and seamless member experience, equip members to thrive in a value-based environment and advance the quality of orthopaedic care, and evolve the culture and governance of AAOS’ Board and volunteer structure to become more strategic, innovative, and diverse

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Apply for Volunteer Opportunities

Consider applying for the following positions:

  • Liaison Activities member position (Commission on Motion Lab Accreditation Board of Directors)—applications are accepted until Jan. 12
  • Liaison Activities member positions (Team Physician Consensus Conference)—applications are accepted until Jan. 12
  • Orthopaedic Video Theater Committee member position (shoulder and elbow)—applications are accepted until Jan. 12
  • Liaison Activities member position (Centers for Medicare & Medicaid Services Technical Expert Panel for Development and Reevaluation of Total Hip and Knee Arthroplasty Outcome Measures)—applications are accepted until Jan. 28
  • International Committee member position—applications are accepted until Jan. 31

Learn more and submit applications…(member login required)