Improving Health: Measuring Effects of Medical Care

Bunker, John P.; Frazier, Howard S.; Mosteller, Frederick

doi:10.2307/3350295

Cited by 228 publications

(116 citation statements)

References 45 publications

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“…Despite increasing demand for TKAs and cost-effectiveness of the procedure [11,16,17], a substantial number of patients who undergo a TKA are dissatisfied with the outcomes, with reported satisfaction rates varying between 75% and 89% [1,6,7,23,24,36,41,51], regardless of patient demographics or severity of disease.…”

Section: Introductionmentioning

confidence: 99%

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

157

114

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Background A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction. Questions/purposes We asked whether (1) psychological factors, as measured by preoperative self-reported questionnaires, predicted poor outcome after TKA, and (2) whether certain psychological factors examined predicted poor outcome better than others. Methods We performed a systematic review and metaanalysis of prospective observational studies published in MEDLINE, CINAHL 1 , EMBASE TM , and PsycINFO 1 databases from their date of inception to October 2013, augmented with a manual search of bibliographies. Study eligibility was performed according to an a priori protocol. Included studies were assessed for quality according to the Newcastle-Ottawa scale. Two reviewers independently performed the search, identified eligible studies, assessed their methodologic quality, and extracted data. Outcomes of interest included postoperative dissatisfaction, pain, or limited function of the patients.

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Section: Introductionmentioning

confidence: 99%

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

157

114

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“…When medical therapy fails to control pain or physical functioning reaches an unacceptable level, total joint arthroplasty (TJA) of the hip or knee is indicated (3,4). Although TJA results in substantial reduction in pain and disability (3)(4)(5)(6)(7), studies indicate that candidates for surgery can be reluctant to consider TJA. For example, in a US study, many African Americans with advanced knee osteoarthritis (OA) reported being unwilling to have surgery, reflecting a belief that it would not significantly improve their current health (8).…”

Section: Introductionmentioning

confidence: 99%

A patient‐centered perspective on surgery avoidance for hip or knee arthritis: Lessons for the future

Ballantyne

Gignac

Hawker

2007

Arthritis & Rheumatism

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Objective. Research indicates that there is a discrepancy between need and patient preference for total joint arthroplasty (TJA), an efficacious and cost-effective treatment for severe hip or knee arthritis. To understand this discrepancy, we conducted qualitative research to assess the illness perceptions and preferred accommodations and coping strategies of patients with advanced osteoarthritis who had expressed a preference to avoid TJA. Methods. In-depth interviews were conducted with a community sample of 29 men and women who were medically assessed as appropriate candidates for TJA but who had expressed a preference to avoid surgery. Inductive content analysis of text data was used to examine how patients' illness perceptions and preferred coping strategies related to surgery preference. Results. Participants frequently rejected the medicalization of arthritis, normalizing the experience of functional decline and defining it as age normative. Participants drew on a broad set of previous experiences with informal and formal care to make decisions about how to manage their condition. Previous negative encounters in medical and surgical care, including those from a distant past or those experienced vicariously, combined with the perception (reinforced by physicians and others) that doing nothing was a viable option deterred arthritis-related help seeking in the health care system. Conclusion. Individuals with arthritis may benefit from additional counseling regarding effective medical and surgical treatments. Physicians may better meet patient needs by gauging patient preferences for a combination of self-management strategies and medical interventions.

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“…It is far from clear, however, that medicine can claim this much credit. An optimistic accounting of the benefits of specific treatments attributes only five years of the forty or more years of added lifespan over the last two centuries to medicine [17].…”

Section: Medicine and Healthmentioning

confidence: 99%

Showing that you care: The evolution of health altruism

Hanson¹

2008

Medical Hypotheses

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Human behavior regarding medicine seems strange; assumptions and models that seem workable in other areas seem less so in medicine. Perhaps we need to rethink the basics. Toward this end, I have collected many puzzling stylized facts about behavior regarding medicine, and have sought a small number of simple assumptions which might together account for as many puzzles as possible.The puzzles I consider include a willingness to provide more medical than other assistance to associates, a desire to be seen as so providing, support for nation, firm, or family provided medical care, placebo benefits of medicine, a small average health value of additional medical spending relative to other health influences, more interest in public that private signals of medical quality, medical spending as an individual necessity but national luxury, a strong stress-mediated health status correlation, and support for regulating health behaviors of the low status. These phenomena seem widespread across time and cultures. I can explain these puzzles moderately well by assuming that humans evolved deep medical habits long ago in an environment where people gained higher status by having more allies, honestly cared about those who remained allies, were unsure who would remain allies, wanted to seem reliable allies, inferred such reliability in part based on who helped who with health crises, tended to suffer more crises requiring non-health investments when having fewer allies, and invested more in cementing allies in good times in order to rely more on them in hard times.These ancient habits would induce modern humans to treat medical care as a way to show that you care. Medical care provided by our allies would reassure us of their concern, and allies would want you and other allies to see that they had pay enough to distinguish themselves from posers who didnt care as much as they. Private information about medical quality is mostly irrelevant to this signaling process.If people with fewer allies are less likely to remain our allies, and if we care about them mainly assuming they remain our allies, then we want them to invest more in health than they would choose for themselves. This tempts us to regulate their health behaviors. This analysis suggests that the future will continue to see robust desires for health behavior regulation and for communal medical care and spending increases as a fraction of income, all regardless of the health effects of these choices.2

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Improving Health: Measuring Effects of Medical Care

Cited by 228 publications

References 45 publications

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

A patient‐centered perspective on surgery avoidance for hip or knee arthritis: Lessons for the future

Showing that you care: The evolution of health altruism

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