The report includes inpatient surgical procedure rates per 1,000 Medicare enrollees from 2008 to 2010 in 19 hospital service areas. Key data points include the following:
• Hip replacement rates varied from 2.3 in Los Angeles to 5.8 in Rochester, Minn. The national average was 3.8.
• Knee replacement rates varied from 4.3 in San Francisco to 11.9 in Salt Lake City. The national average was 8.8.
• Back surgery rates varied from 2.4 in Temple, Texas, to 6.3 in Nashville, Tenn. The national average was 4.7.
The authors wrote that variation in orthopedic surgeries results in important differences in surgical training. "A resident trained in Salt Lake City may be more likely to learn a treatment style involving surgery than in New York City, where a resident might more readily prescribe physical therapy," according to the report.
One of the reasons for the high variation is the number of options available for different conditions, such as knee osteoarthritis or back pain due to disc herniation, the authors wrote. They suggested physicians fully inform patients about treatment options and share treatment decisions to determine appropriate treatment.
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