An Analysis of Women’s and Men’s Surgical Priorities and Willingness to Have Rheumatoid Hand Surgery

Alderman, Amy K.; Arora, Anjali S.; Kuhn, Latoya; Wei, Yongliang; Chung, Kevin C.

doi:10.1016/j.jhsa.2006.08.018

Cited by 35 publications

(23 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A similar trend has been noted in patients with hip and knee OA [10]. This might be explained by differences in attitudes toward surgery between men and women, because some data suggest that women are more fearful of surgery than men, and women are more concerned about the postoperative recovery time, postoperative pain, risks of anesthesia, and complications [1]. Another study found that women are more willing to delay surgery to await better technology and avoid disrupting of their caregiver roles [12].…”

Section: Discussionsupporting

confidence: 57%

“…Our study measured this practice variation and related costs in the first year after the diagnosis of hand OA in patients. Specifically, we looked at the following: (1) What factors are associated with increased costs and surgeries during the first year after diagnosis of hand OA? (2) How much practice variation exists among hand surgeons in terms of the number of patient visits, use of imaging tests, use of injections, occupational therapy use, and surgical intervention in treating patients with hand OA?…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Medical Services and Associated Costs Vary Widely Among Surgeons Treating Patients With Hand Osteoarthritis

Becker

Teunis

Blauth

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background There are substantial variations in medical services that are difficult to explain based on differences in pathophysiology alone. The scale of variation and the number of people affected suggest substantial potential to lower healthcare costs with the reduction of practice variation. Our study assessed practice variation across three affiliated urban sites in one city in the United States and related healthcare costs following the diagnosis of hand osteoarthritis (OA) in patients. Questions/purposes (1) What are the factors associated with increased costs and surgery in the first year after diagnosis of hand OA? (2) How much practice variation exists among hand surgeons in terms of the number of patient visits, use of imaging tests, use of injections, occupational therapy use, and surgery? (3) What proportion of total cost is accounted for by patients who consult with an additional provider? Methods Patients receiving a new diagnosis of primary hand OA between January 1, 2007, and December 31, 2011, were identified from the research database of three affiliated urban hospitals in a single city in the United States. We included 2814 patients (69%, 1929 women) treated by six hand surgeons. We recorded all visits, imaging tests, injections, occupational therapy visits, and surgical procedures in the first year after that diagnosis. Costs were extracted from the Medicare Physician Fee Schedule. Reliability of the database was assessed by manual checking of 120 patient charts (4.3% of all data); reliability was determined to be 94% (113 of 120) for diagnoses, 97% (116 of 120) correct surgeon, 100% (120 of 120) second surgeon, 99% (278 of 282) visits, 99% (132 of 134) imaging procedures, 92% (11 of 12) injections, 95% (21 of 22) surgical procedures, and 85% (102 of 120) prescribing occupational therapy.One of the authors (SJEB) is supported by Dutch research grants from Anna Foundation|NOREF (less than USD 10,000) (Oegstgeest, The Netherlands), Genootschap Noorthey (less than USD 10,000) (Bussum, The Netherlands), Stichting Fonds Doctor Catharine van Tussenbroek (less than USD 10,000) (Amsterdam, The Netherlands), and Stichting Vreedefonds (less than USD 10,000) (Amsterdam, The Netherlands). One of the authors (TT) received research grants from the Prince Bernhard Culture Fund & Kuitse Fung (less than USD 10,000) (Amsterdam, The Netherlands) and Fundatie van de Vrijvrouwe van Renswoude te's-Gravenhage (less than USD 10,000) (The Hague, The Netherlans). One of the authors (DR) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period from Wright Medical (less than USD 10,000) (Memphis, TN, USA); Skeletal Dynamics (less than USD 10,000) (Miami, FL, USA); Biomet (less than USD 10,000) (Warsaw, IN, USA); AO North America (less than USD 10,000) (Paoli, PA, USA); and AO International (less than USD 10,000) (Dubendorf, Switzerland). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and boa...

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Medical Services and Associated Costs Vary Widely Among Surgeons Treating Patients With Hand Osteoarthritis

Becker

Teunis

Blauth

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…20 This has also been shown in rheumatoid hand surgery with men more likely than women to receive an early, prophylactic hand procedure; women were more concerned with the recovery time, post-operative pain and risks of surgery or post-operative complications than their male counterparts. 21 Gender differences in the uptake of surgical procedures has been suggested by Katz et al 20 to reflect the greater value men place on their physical function than women, and therefore their willingness to accept the greater potential risk to improve their functional status. They also suggest that practical considerations such as life roles and the need for increased care while rehabilitating may prompt women to defer surgery for as long as possible.…”

Section: Discussionmentioning

confidence: 99%

Upper limb reconstructive surgery uptake for persons with tetraplegia in New Zealand: a retrospective case review 2001–2005

Dunn

Hay‐Smith²,

Whitehead

et al. 2010

Spinal Cord

View full text Add to dashboard Cite

Study design: Retrospective case series. Objective: To describe the uptake of upper limb surgery by individuals with tetraplegia in New Zealand (NZ). Setting: New Zealand. Methods:The clinical notes of all individuals who sustained a cervical spinal cord injury between 1 January 2001 and 31 December 2005 were retrospectively reviewed for those who met the clinical criteria to undergo upper limb surgery. Cases were cross-referenced to the hand surgery record to determine the uptake of upper limb surgery in this cohort. Results: The uptake of upper limb surgery for people with tetraplegia in NZ was 44% of the eligible cohort and 59% of those assessed for surgery. This is notably higher than the reported proportion in other developed countries. The data also suggested that women and those who identified as NZ Maori were less likely to undergo upper limb surgery than were men and those of NZ European ethnicity. Conclusion: Utilization of upper limb surgery in the eligible tetraplegic population in NZ was high. However, it seemed that some groups were less likely to undergo surgery. Further research into the factors that affect an individual's decision to undergo upper limb surgery could explain the observed pattern.

show abstract

“…Data was collected from a cohort spanning 22 years (1990 to 2012). Table 1 shows the index procedures which were broadly classified and pooled into three groups: [1] tenosynovectomy and soft tissue procedures, [2] wrist arthrodesis/arthroplasty and [3] finger arthrodesis/ arthroplasty. Case notes were reviewed, and those patients with a confirmed clinical diagnosis of rheumatoid arthritis (RA) were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Rheumatoid Hand Surgery: Is there a Decline? A 22-Year Population-Based Study

Gogna

Cheung

Arundell

et al. 2014

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

An Analysis of Women’s and Men’s Surgical Priorities and Willingness to Have Rheumatoid Hand Surgery

Cited by 35 publications

References 35 publications

Medical Services and Associated Costs Vary Widely Among Surgeons Treating Patients With Hand Osteoarthritis

Medical Services and Associated Costs Vary Widely Among Surgeons Treating Patients With Hand Osteoarthritis

Upper limb reconstructive surgery uptake for persons with tetraplegia in New Zealand: a retrospective case review 2001–2005

Rheumatoid Hand Surgery: Is there a Decline? A 22-Year Population-Based Study

Contact Info

Product

Resources

About