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Health Serv Res Manag Epidemiol. 2015 Jul 31;2:2333392815598310. doi: 10.1177/2333392815598310. eCollection 2015 Jan-Dec.

Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing.

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RAND Corporation, Pittsburgh, PA, USA.
RAND Corporation, Boston, MA, USA.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
HealthCore, Wilmington, DE, USA.
Department of Orthopaedic Surgery, University of California, Los Angeles, Santa Monica, CA, USA.


Health plans are encouraging consumerism among joint replacement patients by reporting information on hospital costs and quality. Little is known about how the proliferation of such initiatives impacts patients' selection of a surgeon and hospital. We performed a qualitative analysis of semistructured interviews with 13 patients who recently received a hip or knee replacement surgery. Patients focused on the choice of a surgeon as opposed to a hospital, and the surgeon choice was primarily made based on reputation. Most patients had long-standing relationships with an orthopedic surgeon and tended to stay with that surgeon for their replacement. Despite growing availability of cost and quality information, patients almost never used such information to make a decision.


consumerism; hip and knee replacement surgery; provider choice; reference pricing

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Two authors are employees of HealthCore, Inc, an independent research subsidiary of WellPoint, Inc.

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