Quality, cost and outcomes measures in orthopaedic healthcare

Abstract

In the era of patient-centred healthcare, good quality medical practice represents an intervention resulting in outcomes that match patients' expectations. However, good quality healthcare is not without a cost, and outcomes measurement is complex and flawed by the multiple layers that exist and define such measurements. To meet the financial challenges faced in the healthcare industry, healthcare organizations are striving to control operational costs. Costing is essential to maximize the resources available to the healthcare providers and increase the services offered to patients. Still, patients' expectations in healthcare continue to increase; patients' expectations are diverse, and subject to variability in space (culture, religion, education, social status, profession, secondary gains) and time. Understanding and adequate management of patients' expectations can enhance their satisfaction level, improve outcomes and decrease liability. In this setting, assessment of outcomes has become increasingly more important in the healthcare industry. This editorial paper discusses the quality and cost of healthcare, the expectations and variances of patients, and the measurements of outcomes for patient-centred care into existing health care systems (Figs. 1 and 2). Quality and cost of healthcareDebate over healthcare often focuses on two key issues: quality and cost. Quality problems may not be the result of Fig. 1

Long bone fractures: treatment patterns and factors contributing to use of intramedullary nailing

“…These health services utilization data reflect payments received for healthcare services and commodities. A better understanding of the interactions that patients with long bone fractures have with the healthcare system can be helpful in improving patient quality of care [19,20]. The benchmarking of care of patients with long bone fractures provides a first step toward the goals of the Triple Aim of simultaneously improving the experience of care, improving the health of populations, and reducing per capita costs of healthcare [21].…”

Occult injuries of the contralateral sacroiliac joint in operatively treated pelvis fractures: incidence, root cause analysis, and proposal of treatment algorithm

“…Multiply traumatized patients with multiple orthopaedic injuries were an independent risk factor for this injury pattern. In the modern healthcare systems driven by costs, outcome, quality, and patient safety [17], careful scrutiny of preoperative imaging may help detect these injuries, and an algorithmic approach to diagnosis, involving an examination under anaesthesia (EUA) of each hemipelvis during temporary or definitive fixation, may help prevent these complications. Intraoperative three-dimensional imaging or post-operative computed tomography (CT) scans could identify these injuries when initially unrecognized.…”

Acknowledgement to our reviewers and to the quality of the English literary expression in “International Orthopaedics”

“…There are sometimes debates about how words should be spelt or used but the final decision must be for the Editor and Editorial Board. We publish Editorials based on some issues which merit debate or on what seems important for us [8][9][10][11][12][13][14][15]. Many of our reviewers, corresponding members or board members are authors or co-authors of those Editorials, helping us to keep an open written interaction with our contributors.…”