This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Brinker, M. R.
Right arrow Articles by Elliott, M. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brinker, M. R.
Right arrow Articles by Elliott, M. N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 84:1926-1932 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Utilization of Orthopaedic Services in a Capitated Population

Mark R. Brinker, MD, Daniel P. O'Connor, MS, PT, ATC, Peggy Pierce, BBA, G. William Woods, MD and Marc N. Elliott, PhD

Investigation performed at The Center for Musculoskeletal Research and Outcomes Studies, Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, Texas

Mark R. Brinker, MD
Peggy Pierce, BBA
G. William Woods, MD
The Center for Musculoskeletal Research and Outcomes Studies, Fondren Orthopedic Group L.L.P., 7401 South Main Street, Houston, TX 77030

Daniel P. O'Connor, MS, PT, ATC
Joe W. King Orthopedic Institute at Texas Orthopedic Hospital, 7401 South Main Street, Houston, TX 77030
Marc N. Elliott, PhD
RAND Corporation, 1700 Main Street, Santa Monica, CA 90401

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The utilization rate for orthopaedic services (office visits and surgery) is not well known. The purpose of this study was to determine the utilization rates for orthopaedic office visits and surgical procedures in a large population of captured lives.

Methods: The study population comprised an average of 134,902 persons per month who were enrolled under a capitated insurance plan between January 1999 and December 1999. This plan was serviced by an independent physician association of sixty-two orthopaedic surgeons who were responsible for all orthopaedic care. Data were collected prospectively and stored in a centralized database. All analyses were conducted with use of monthly averages. Poisson regression was used to compare utilization rates and to calculate odds ratios in order to determine whether the utilization rates varied by age and gender.

Results: The highest proportions of office visits were due to fractures (21%), osteoarthritis (4%), meniscal tears (4%), and low-back pain or sciatica (4%). Knee arthroscopy (30%), foot and ankle procedures (10%), and spine procedures (9%) accounted for the highest proportions of surgical procedures. The overall utilization rates were 6.96 office visits and 1.99 surgical procedures per 1000 covered lives per month. Across all age groups, males and females did not differ with respect to the utilization rate for office visits (p = 0.42) or surgery (p = 0.09). Increased age was significantly related to increased utilization rates for office visits (p £ 0.0002) and surgery (p <= 0.002).

Conclusions: These data may be used to determine the size of a capitated population that an orthopaedic practice can accommodate, to determine the number of orthopaedic providers that is needed to provide services for a capitated population, and to estimate the expenses associated with providing orthopaedic services for a capitated population in an orthopaedic practice.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
C. C. Crouch, D. P. O'Connor, P. Pierce, and M. R. Brinker
Utilization of Orthopaedic Services for Hand and Wrist Conditions in a Capitated Population
J. Bone Joint Surg. Am., January 1, 2004; 86(1): 51 - 56.
[Abstract] [Full Text] [PDF]