TY - JOUR
T1 - Valuing the Recovery Priorities of Orthopaedic Trauma Patients after Injury
T2 - Evidence from a Discrete Choice Experiment Within 6 Weeks of Injury
AU - O'Hara, Nathan N.
AU - Mulliken, Alexandra
AU - Joseph, Katherine
AU - Slobogean, Gerard P.
AU - Johal, Herman
AU - Cunningham, Brian P.
AU - Olaya, Stephan
AU - Levy, Joseph
AU - Pollak, Andrew N.
AU - Klazinga, Niek S.
N1 - Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives:To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities.Design:Discrete choice experiment.Setting:Academic trauma center.Patients:One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non-English-speaking patients were excluded.Main Outcome Measurement:The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury.Results:In the subacute period, clinical recovery was the main priority for fracture patients (mean: 62%, SD: 5.3). Work-related recovery (mean: 27%, SD: 3.9) and the receipt of other disability benefits (mean: 11%, SD: 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture.Conclusion:Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care.Level of Evidence:Level V. See Instructions for Authors for a complete description of levels of evidence.
AB - Objectives:To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities.Design:Discrete choice experiment.Setting:Academic trauma center.Patients:One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non-English-speaking patients were excluded.Main Outcome Measurement:The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury.Results:In the subacute period, clinical recovery was the main priority for fracture patients (mean: 62%, SD: 5.3). Work-related recovery (mean: 27%, SD: 3.9) and the receipt of other disability benefits (mean: 11%, SD: 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture.Conclusion:Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care.Level of Evidence:Level V. See Instructions for Authors for a complete description of levels of evidence.
KW - discrete choice experiment
KW - fracture
KW - recovery
KW - value-based health care
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U2 - 10.1097/BOT.0000000000001621
DO - 10.1097/BOT.0000000000001621
M3 - Article
C2 - 31596779
AN - SCOPUS:85073097932
SN - 0890-5339
VL - 33
SP - S16-S20
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
ER -