Welcome to the Orthopaedic Policy, Outcomes, and Disparities (OrthoPOD) Lab
Osteoarthritis is the 2nd most expensive condition treated in US hospitals and accounts for 19 billion dollars in annual inpatient spending. Joint replacements for osteoarthritis and spinal fusion surgeries are among the top five surgeries performed in hospitals. However, despite the high volume and costs of orthopaedic surgeries, there is considerable variation in the use and outcomes of these surgeries. For example, there is a 3-fold variation in the use of joint replacements across regions in the US, and post-operative complication rates range from 1.8% to 8.9% following these surgeries. Moreover, there are widespread and persistent racial, ethnic, and socioeconomic disparities in the use and outcomes of orthopaedic surgeries. As recently as 2017, joint replacement rates were 38-40% lower among Black Medicare beneficiaries than White Medicare beneficiaries, with income being an important moderator of these disparities. Importantly, given the volume, costs, and variation that exists, orthopaedic surgeries are the focus of several delivery and payment reforms that have aimed to improve quality and reduce costs. Whether these reforms can achieve their intended endpoints is an open question.
Thus, the goal of the OrthoPOD lab is to measure what is done in orthopaedics, generate rigorous empirical evidence that influences policy and practice, and thereby make a significant difference in the lives of orthopaedic patients. Our lab investigates issues relating to the access, outcomes, disparities, and costs of orthopaedic care. An overarching focus of our investigation is how delivery and payment reforms/policies influence these orthopaedic endpoints. We use health services research (HSR) approaches to examine our research questions. These approaches integrate (i) theory- and literature-based conceptual frameworks, (ii) empirically rigorous quantitative (econometric/statistical) and qualitative methods, and (iii) clinical perspectives to address high-priority orthopaedic research questions. Our research involves the use of large national, state, and local datasets that are generated from the administrative and medical records of patients who seek orthopaedic care.
Thank you for your interest in our research!