Joint Replacement Soars as Number of Docs Falls

Medical Tourism - A Valid Solution To Projected Shortage

The potential shortage of orthopedic surgeons available in the U.S. to meet the increased demand in joint replacement procedures may be alleviated in the global market for healthcare services. A full-fledged industry in North America has already been established to assist uninsured and underinsured citizens obtain surgical procedures abroad at a fraction the cost. Referred to as “medical tourism,” the key players in this industry have already established affiliations with international hospitals that are accredited by the Joint Commission, the same accreditation organization that accredits hospitals in the U.S. In just the past year, joint replacement procedures have become among the most popular procedures sought by North American patients, considering treatment overseas.

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Costs are dropping as benefits rise

The data indicating that reimbursement for joint replacement therapy has decreased 60 percent in inflation adjusted dollars since 1990 should be considered within the context of claims that medical technology is responsible for driving up the cost of health care.

At the Institute for Health Technology Studies (InHealth), we fund academic research into the impact and value of medical technology innovation. Investigators at Duke University found that patients eligible for knee or hip replacement that go ahead with the procedure enjoy significant quality of life benefits and reduced disability. [George, Linda K., David Ruiz, Jr. and Frank A. Sloan. “The Effects of Total Hip Arthroplasty on Physical Functioning in the Older Population.” Journal of American Geriatrics Society. (June 2008) 1057-1062, and George, Linda K., David Ruiz, Jr. and Frank A Sloan. “The Effects of Total Knee Arthroplasty on Physical Functioning in the Older Population.” Arthritis & Rheumatism. (October 2008) 3166-3171.]

So costs are falling and benefits are rising.

This is an inverse relationship that is rarely acknowledged among those who will reform health care. At InHealth we have on-going discussions of many of these issues (www.deliveringevidence.inhealth.org) but suffice to say here that when reforming health care we must exercise great caution before we jump to premature conclusions about the impact of new technologies on costs.