Today’s Top Story
Study: Hospital programs may help reduce or eliminate “weekend effect.”
Data from a study published in the October issue of the journal Annals of Surgery suggest that improving hospital perioperative infrastructure may help overcome disparities in surgical care such as the so-called “weekend effect,” in which surgeon-independent patient outcomes have been observed to be worse on the weekend compared with weekdays. The research team reviewed data on 126,666 patients across 166 hospitals in Florida. They found that during the 5-year study period, 17 hospitals overcame the “weekend effect.” Predictors associated with overcoming the “weekend effect” included full adoption of electronic health records, home health program, pain management program, increased registered nurse-to-bed ratio, and inpatient physical rehabilitation. Read more…
Read the abstract…

Other News

Study: How accurate are various CT methods for assessing glenoid bone defects?
According to a study published online in The American Journal of Sports Medicine, computed tomography (CT) assessment of glenoid bone defects with and without comparison with the contralateral shoulder display good agreement in identifying the size, presence, and type of defect in patients with anterior shoulder instability on both 2D and 3D CT scans. The authors conducted a prospective, cohort study of 200 patients with unilateral anterior shoulder instability who underwent CT of both shoulders. The authors used the circle method to calculate the area of missing glenoid, based on four sets of CT scans: 2D and 3D CT images with and without comparison with the contralateral shoulder. They found that the mean difference between the four measures was less than 1 percent of the area of the inferior glenoid in each pairwise comparison, and the limits of agreement were always below the established acceptable limit of 5 percent. “The assessment of the presence and type of bone defect showed strong to near-complete agreement between the [four] measurement methods,” the authors write. Read the abstract…

Study: TXA may help reduce blood loss after shoulder arthroplasty.
Data from a study published in the November issue of the Journal of Shoulder and Elbow Surgery suggest that shoulder arthroplasty patients treated with tranexamic acid (TXA) may experience less postoperative blood loss and a smaller change in hemoglobin level compared with those treated with placebo. The researchers conducted a prospective, double-blind, randomized trial of 111 patients who underwent shoulder arthroplasty and received either 100 mL of normal saline or 100 mL of normal saline with 2 g TXA by topical application into the wound at completion of the procedure. They found that average blood loss after surgery was 170 mL in the placebo group and 108 mL in the TXA group, while the average change in hemoglobin level was 2.6 g/dL in the placebo group and 1.7 g/dL in the TXA group. Read the abstract…

Do quality measures disproportionately affect safety net hospitals?
A perspective piece in Forbes looks at the issue of pay-for-performance, supporting the concept, but noting that implementation may negatively affect hospitals that care for low-income patients. “In practice,” the writer argues, “pay-for-performance is only as good as the quality measures used to determine performance. And Medicare’s measures, by placing significant weight on patient satisfaction scores, are hurting hospitals that disproportionately care for low-income populations.” Despite having similar outcomes based on objective measures such as mortality rates, safety net hospitals have been found to receive lower patient satisfaction scores than other hospitals, which can reduce reimbursement under current Medicare quality programs. Read more…

Pennsylvania.
The U.S. Federal Trade Commission (FTC) has announced a proposed settlement with two orthopaedic practices in Berks County, Pa., that the agency claimed had engaged in anticompetitive behavior. According to the FTC, a single, large practice was created through the 2011 merger of six independent orthopaedic physicians groups, with 19 of 25 orthopaedists in the county. The agency charged that the merger violated U.S. antitrust law. Under terms of the proposed settlement, that practice and another that separated from it in 2014 are required to obtain prior approval from FTC before acquiring any interests in each other, before acquiring another orthopaedic practice in Berks County, and before hiring or offering membership to an orthopaedist who has provided services in Berks County in the past year. In addition, both practices are prohibited from coordinating their prices with other orthopaedists in the market and jointly negotiating with or refusing to deal with payers, and must also terminate without penalty, any existing contracts with payers for the provision of orthopaedic physician services at the payer’s request. Read more…

Vermont.
AMA Wire reports that the U.S. Supreme Court plans to consider a case that could affect transparency of health insurance payments. At issue is whether the federal Employee Retirement Income Security Act of 1974 (ERISA) preempts a Vermont law that requires health insurers to submit claims payment data to an all-payer claims database maintained by the state. A federal appeals court has ruled that ERISA preempts application of Vermont’s claims database statute to the self-funded health benefit plan of a private insurer, concluding that the statute intruded on “one of ERISA’s core functions.” Read more…

Member registration for 2016 AAOS Annual Meeting opens this Wednesday!
Member housing is now open for the 2016 AAOS Annual Meeting, and member registration will open Oct. 21. In addition, the preliminary meeting program is now available online. The 2016 AAOS Annual Meeting will take place March 1–5, 2016, in Orlando, Fla. Learn more about the AAOS Annual Meeting…

Call for abstracts: AAOS/ORS Tackling Joint Disease by Understanding Crosstalk between Cartilage and Bone Research symposium.
Dec. 1, 2015, is the last day to submit abstracts for the AAOS/Orthopaedic Research Society (ORS) Tackling Joint Disease by Understanding Crosstalk between Cartilage and Bone Research Symposium. AAOS and ORS seek abstracts in the areas of bone and cartilage biology, biomechanics, mechanobiology, the microbiome, exosomes, genomics and other relevant areas as they relate to crosstalk between bone and cartilage. Abstracts should concisely communicate the significance, hypothesis, methods, results, and conclusions of the study. In addition, 15 Young Investigator travel awards are available for abstracts of high quality research. The symposium will be held April 28-30, 2016, in Rosemont, Ill. For more information, contact Erin Ransford, AAOS manager, research advocacy, at: ransford@aaos.org
Learn more about the symposium…