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Trends and regional variation in hip, knee, and shoulder replacement a Dartmouth Atlas surgery report

From 2000-01 to 2005-06, rates of hip, knee, and shoulder replacement all rose substantially among Medicare beneficiaries, and there was widespread variation in the use of these procedures across geographic regions and by race. The Dartmouth Atlas Project has detailed similar variation in the use of...

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Bibliographic Details
Main Authors: Fisher, Elliott S., Bell, John-Erik (Author), Tomek, Ivan M. (Author), Esty, Amos R. (Author)
Corporate Authors: Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Atlas Project
Format: eBook
Language:English
Published: [Lebanon, N.H.] The Dartmouth Institute for Health Policy and Clinical Practice 2010, April 6, 2010
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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700 1 |a Tomek, Ivan M.  |e [author] 
700 1 |a Esty, Amos R.  |e [author] 
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520 |a From 2000-01 to 2005-06, rates of hip, knee, and shoulder replacement all rose substantially among Medicare beneficiaries, and there was widespread variation in the use of these procedures across geographic regions and by race. The Dartmouth Atlas Project has detailed similar variation in the use of other elective procedures. One possible interpretation of this variation is that the decision to undergo the procedure may be influenced more by physician judgments than by the preferences and values of the individual patients. Another explanation might be that patients in some geographical areas do not have adequate access to joint replacement. These findings highlight the need for improved physician and patient education and the use of shared decision-making to determine whether a patient should undergo joint replacement 

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