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. 2024 Oct 18;6(4):100532.
doi: 10.1016/j.ocarto.2024.100532. eCollection 2024 Dec.

Referral, enrollment, and health care use in a comprehensive patient-centered management program for osteoarthritis of the hip and knee

Trevor A Lentz  1   2   3 , Preston Roundy  4 , Emily Poehlein  5 , Cynthia L Green  1   5 , Richard C Mather 3rd  2   3 , William Jiranek  2
Affiliations

Referral, enrollment, and health care use in a comprehensive patient-centered management program for osteoarthritis of the hip and knee

Trevor A Lentz et al. Osteoarthr Cartil Open. .

Abstract

Objective: Osteoarthritis management programs (OAMPs) have become a more common way to deliver patient-centered care. However, there is limited information on real-world use of these programs to guide implementation, payment policy, accessibility, and scaling in the United States. This paper describes 5-year use metrics for the Duke Joint Health Program, an OAMP embedded within a US academic health system.

Method: This analysis includes patients referred into the Program between October 2017 and April 2022. We generated descriptive statistics of referral and enrollment totals, demographics and patient-reported measures of enrollees, retention and healthcare use metrics (e.g., office visit frequency), and data capture rates for patient-reported outcomes.

Results: During the study period, 6863 patients were referred to the program and 4162 (61 ​%) enrolled. We observed statistically significant differences between those who did and did not enroll by age (mean difference ​± ​SE: 2.49 ​± ​2.8 years), sex (70.0 ​% vs 67.7 ​% female), race (65.1 ​% vs 55.3 ​% Caucasian/White), employment status (50.0 ​% vs 40.2 ​% retired), and insurance type (53.5 ​% vs 47.0 ​% Medicare). The median (Q1, Q3) number of visits was 2 (1, 4) and ranged from 1 to 67. The median (Q1, Q3) number of days from first to last program visit was 23 (0, 84) days. Questionnaire completion rates were 72 ​% at baseline, 46 ​% at 6 weeks, 39 ​% at 3 months, and 40 ​% at 6 and 12 months.

Conclusion: Findings can guide the planning, development, and implementation of future OAMPs and inform policies to ensure programs are accessible and equitable.

Keywords: Comprehensive care; Health services research; Multidisciplinary; Utilization.

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Conflict of interest statement

All authors are employed by Duke University or the Duke University Health System. TL receives research funding from the NIH and ATI Holdings, LLC. Authors report no other competing interests.

Figures

Fig. 1
Fig. 1
Patient flow into and through the Program with key factors that can influence the process.
Fig. 2
Fig. 2
Flow diagram for developing final analytic dataset.
Fig. 3
Fig. 3
Number of POP visits for those enrolled in the Duke Joint Health Program.
Fig. 4
Fig. 4
Number of days from enrollment to last POP visit for those enrolled in the Duke Joint Health Program.
See this image and copyright information in PMC

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