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Factors driving physician-hospital alignment in orthopaedic surgery.
Clin Orthop Relat Res. 2013 Jun; 471(6):1809-17.CO

Abstract

BACKGROUND

The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging.

QUESTIONS/PURPOSES

Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals.

METHODS

We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite.

RESULTS

Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services.

CONCLUSIONS

Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

Authors+Show Affiliations

Kaiser Permanente, San Diego, CA, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23229427

Citation

Page, Alexandra E., et al. "Factors Driving Physician-hospital Alignment in Orthopaedic Surgery." Clinical Orthopaedics and Related Research, vol. 471, no. 6, 2013, pp. 1809-17.
Page AE, Butler CA, Bozic KJ. Factors driving physician-hospital alignment in orthopaedic surgery. Clin Orthop Relat Res. 2013;471(6):1809-17.
Page, A. E., Butler, C. A., & Bozic, K. J. (2013). Factors driving physician-hospital alignment in orthopaedic surgery. Clinical Orthopaedics and Related Research, 471(6), 1809-17. https://doi.org/10.1007/s11999-012-2730-8
Page AE, Butler CA, Bozic KJ. Factors Driving Physician-hospital Alignment in Orthopaedic Surgery. Clin Orthop Relat Res. 2013;471(6):1809-17. PubMed PMID: 23229427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors driving physician-hospital alignment in orthopaedic surgery. AU - Page,Alexandra E, AU - Butler,Craig A, AU - Bozic,Kevin J, PY - 2012/12/12/entrez PY - 2012/12/12/pubmed PY - 2013/6/26/medline SP - 1809 EP - 17 JF - Clinical orthopaedics and related research JO - Clin. Orthop. Relat. Res. VL - 471 IS - 6 N2 - BACKGROUND: The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. QUESTIONS/PURPOSES: Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. METHODS: We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. RESULTS: Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. CONCLUSIONS: Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care. SN - 1528-1132 UR - https://www.unboundmedicine.com/medline/citation/23229427/Factors_driving_physician_hospital_alignment_in_orthopaedic_surgery_ L2 - https://link.springer.com/article/10.1007/s11999-012-2730-8 DB - PRIME DP - Unbound Medicine ER -