Men have a greater number of knee ligament injuries than women, despite research suggesting that women's knees are more prone to anterior cruciate ligament (ACL) tears and surgeries to fix them, says an article by Reuters based on study in American Journal of Sports Medicine.
For this study, researchers included knee injuries across the entire Swedish population, not just among players of particular sports or in certain regions. They used a nationwide database of patients to see how many Swedes had knee ligament injuries and how many had surgical repairs between 2002 and 2009. Overall, 56,659 people in Sweden tore a knee ligament during the 7-year study period—an average of 78 tears for every 100,000 Swedish citizens.
Men accounted for about 34,000 of the tears, or 60%. Men also had 59% of the reconstructive surgeries associated with knee ligament injuries.
Swedish women tended to experience ACL injuries at a younger age—between the ages of 11 and 20, versus 21 to 30 for men.
When the researchers looked just at the age groups with the highest injury rates, men still had far more knee troubles. The numbers worked out to about 144 tears per 100,000 women between 11 and 20 years old, and 225 tears per 100,000 men aged 21 to 30.
Darin Padua, director of the Sports Medicine Research Laboratory at the University of North Carolina at Chapel Hill, said he was not surprised by the findings. Padua, who was not involved with the research, added that the results help to show that both men and women should be taking part in injury prevention programs, the article says.
Physician-hospital consolidation for the purpose of enhanced bargaining power with payers does not lead to true integration or enhanced hospital performance, according to an updated issue brief by the Robert Wood Johnson Foundation (RWJF) that examines the effect of hospital mergers on prices, costs, and quality of care.
Consolidation between physicians and hospitals is of great interest because of both the potential that consolidation has for creating integration, and the impetus created by the Affordable Care Act's push toward creating accountable care organizations and emphasis on bundled payments. In theory, says the brief, there are substantial gains to be made from consolidation—especially when consolidation leads to integration and the elimination of unnecessary duplication of services.
However, the brief also points to concerns that consolidation may have adverse impacts on competition. Hospital consolidation generally results in higher prices. When hospitals merge in already concentrated markets, the price increase can be dramatic, often exceeding 20%.
Additionally, hospital competition improves quality of care. This is true under both administered price systems such as Medicare and the United Kingdom's National Health Service, and market-determined pricing such as the private health insurance market.
The full 2006 synthesis and updated brief are available on RWJF's website.