Understanding consumer and clinician preferences and decision making for rehabilitation following arthroplasty in the private sector

Mark A. Buhagiar*, Justine M. Naylor, Grahame Simpson, Ian A. Harris, Friedbert Kohler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
49 Downloads (Pure)

Abstract

Background: To understand private consumer and clinician preferences towards different rehabilitation modes following knee or hip arthroplasty, and identify factors which influence the chosen rehabilitation pathway. Methods: Mixed methods cross-sectional study involving 95 semi-structured interviews of consumers (patients and carers) and clinicians (arthroplasty surgeons, physiotherapists and rehabilitation physicians) in Sydney, Australia, during 2014-2015. Participants were asked about the acceptability of different modes of rehabilitation provision, and factors influencing their chosen rehabilitation pathway. Interviews were in person or via the telephone. Qualitative analysis software was used to electronically manage qualitative data. An analytical approach guided data analysis. Results: Pre-operative preferences strongly influenced the type of rehabilitation chosen by consumers. Key factors that influenced this were both intrinsic and extrinsic, including; the previous experience of self or known others, the perceived benefits of the chosen mode, a sense of entitlement, the role of orthopaedic surgeons and influence of patient preference, a patient's clinical status post-surgery, the private hospital business model and insurance provider involvement. The acceptability of rehabilitation modes varied between clinician groups. Conclusions: No one rehabilitation mode provided following arthroplasty is singularly preferred by stakeholders. Factors other than the belief that a particular mode was more effective than another appear to dominate the pathway followed by private arthroplasty consumers, indicating evidence-based policies around rehabilitation provision may have limited appeal in the private sector.

Original languageEnglish
Article number415
Pages (from-to)1-10
Number of pages10
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
Publication statusPublished - 19 Jun 2017
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • consumer preference
  • clinician preference
  • joint arthroplasty
  • rehabilitation

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