Appropriateness criteria and elective procedures--total joint arthroplasty.

@article{Ghomrawi2012AppropriatenessCA,
  title={Appropriateness criteria and elective procedures--total joint arthroplasty.},
  author={Hassan M K Ghomrawi and Bruce R. Schackman and Alvin I. Mushlin},
  journal={The New England journal of medicine},
  year={2012},
  volume={367 26},
  pages={
          2467-9
        }
}
The implementation of appropriateness criteria that help to identify the patients likely to benefit most from a given procedure could help to combat increasing health care costs while enhancing access and quality. Total joint arthroplasty offers a prime example. 
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The need for a tool to support decision making for TJA, particularly in the context of increasing surgical demand in younger patients with less severe arthritis, is recognized, and work to develop and test such a decision-support tool is underway.
Factors Associated With Referral to Secondary Care in Patients With Osteoarthritis of the Hip or Knee After Implementation of a Stepped‐Care Strategy
TLDR
This study aimed to identify factors associated with various steps of the SCS, focusing on delivery of high‐quality stepped care in hip and knee osteoarthritis patients.
Length Hip and knee arthroplasty utilization and outcomes in the United States and Canada : an analysis of New York and Ontario administrative data
Objective: Total knee and total hip arthroplasty (TKA and THA) are common and effective surgical procedures. We compared utilization and short-term outcomes of primary TKA and THA in adjacent regions
Effect of age on cost-effectiveness of unicompartmental knee arthroplasty compared with total knee arthroplasty in the U.S.
TLDR
Unicompartmental knee arthroplasty is an economically attractive alternative in patients sixty-five years of age or older, and modest improvements in implant survivorship could make it a cost-effective alternative in younger patients.
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References

SHOWING 1-7 OF 7 REFERENCES
Appropriateness of primary total hip and knee replacements in regions of Ontario with high and low utilization rates.
TLDR
Patients selected for primary hip or knee replacement are similar in the high- and low-rate regions of Ontario, although the patients' baseline characteristics, including severity of preoperative pain and dysfunction, were otherwise similar between the regions.
Appropriateness criteria to assess variations in surgical procedure use in the United States.
TLDR
Most existing AC are outdated, and AC have never been developed for most common surgical procedures, so a broad and coordinated effort is required to implement this tool to address variation in the use of surgical procedures.
Prevalence of knee and hip osteoarthritis and the appropriateness of joint replacement in an older population.
TLDR
Knee and hip osteoarthritis are highly prevalent diseases in the older population and the estimation of appropriateness for hip replacement seems to be significantly higher than that for knee replacement.
HAS EVIDENCE CHANGED PRACTICE? APPROPRIATENESS OF CAROTID ENDARTERECTOMY AFTER THE CLINICAL TRIALS
TLDR
This study sought to overcome the lack of country-specific data by two means to generate estimates of the number of people with Parkinson disease by using age-specific prevalence by country where available and where not available.
Where Americans get acute care: increasingly, it's not at their doctor's office.
TLDR
Health reform provisions in the Patient Protection and Affordable Care Act that advance patient-centered medical homes and accountable care organizations are intended to improve access to acute care.
National trends in emergency department occupancy, 2001 to 2008: effect of inpatient admissions versus emergency department practice intensity.
TLDR
Although hospital admission generated longer ED stays than any other factor, it did not influence the steep trend in occupancy, and Sociodemographic changes account for some of the increase, but practice intensity is the principal factor driving increasing occupancy levels.
Future Young Patient Demand for Primary and Revision Joint Replacement: National Projections from 2010 to 2030
TLDR
If the historical growth trajectory of joint replacement surgeries continues, demand for primary THA and TKA among patients less than 65 years old was projected to exceed 50% of THAand TKA patients of all ages by 2011 and 2016, respectively.