Experiences with and perception of patient-reported outcome measurement in patients undergoing knee and hip replacement in Germany

BACKGROUND

Patient-reported outcome measures - PROMs - have been developed to provide an assessment of patients' physical function, symptoms, and health-related quality of life. With patient-centered care becoming increasingly important, several national strategies have been initiated for PROM measurement. However, Germany is only at the beginning of this process. The objective of this study is to assess patients' experience with and perception of completing PROMs in patients undergoing knee and hip replacement in Germany.

METHODS

This study used survey data from patients undergoing hip or knee replacement surgery in a hospital in Germany. Before surgery, patients completed a PROMs survey. After at least 6 months, patients were re-contacted to fill in a questionnaire about their experiences with and perception of the PROMs data collection.

RESULTS

Most patients either agreed or totally agreed that the time to fill in the questionnaire was appropriate (89%), that the purpose of the PROMs collection was clear (85%), that the questionnaire's content applied to their appointment (73%), and that this systematic assessment was beneficial (81%). The corresponding proportions were 54% for feeling productive while waiting and 50% for feeling that the information in the questionnaire affected the patient-doctor interaction positively. Only few significant associations were found between patient characteristics and the favorability of patients' ratings. There were no significant differences between hip and knee replacement surgery patients regarding the favorability rating on any survey question.

CONCLUSIONS

The results of this study suggest that PROMs collection in the context of hip and knee replacement surgery is practicable and partly also perceived beneficial by patients. Orthopedic procedures could serve as a starting point for broader use and routine PROMs collection in Germany.

The effect of differential privacy on Medicaid participation among racial and ethnic minority groups

OBJECTIVE

To investigate how county and state-level estimates of Medicaid enrollment among the total, non-Hispanic White, non-Hispanic Black or African American, and Hispanic or Latino/a population are affected by Differential Privacy (DP), where statistical noise is added to the public decennial US census data to protect individual privacy.

DATA SOURCES

We obtained population counts from the final version of the US Census Bureau Differential Privacy Demonstration Products from 2010 and combined them with Medicaid enrollment data.

STUDY DESIGN

We compared 2010 county and state-level population counts released under the traditional disclosure avoidance techniques and the ones produced with the proposed DP procedures.

DATA COLLECTION/EXTRACTION METHODS

Not applicable.

PRINCIPAL FINDINGS

We find the DP method introduces errors up to 10% into counts and proportions of Medicaid participation rate accuracy at the county level, especially for small subpopulations and racial and ethnic minority groups. The effect of DP on Medicaid participation rate accuracy is only small and negligible at the state level.

CONCLUSIONS

The implementation of DP in the 2020 census can affect the analyses of health disparities and health care access and use among different subpopulations in the United States. The planned implementation of DP in other census-related surveys such as the American Community Survey can misrepresent Medicaid participation rates for small racial and ethnic minority groups. This can affect Medicaid funding decisions.

The causal impact of sugar taxes on soft drink sales: evidence from France and Hungary

Sugar-sweetened beverages (SSBs) are associated with increased body weight and obesity, which induce a wide array of health impairments such as diabetes or cardiovascular disorders. Excise taxes have been introduced to counteract SSB consumption. We investigated the effect of sugar taxes on SSB sales in Hungary and France using a synthetic control approach. For France, we found a slight decrease in SSB sales after tax implementation while overall soft drink sales increased. For Hungary, there was only a short-term decrease in SSB sales which disappeared after 2 years, leading to an overall increase in SSB sales. However, both effects are characterized by great uncertainty.