The effect of payer type on clinical outcomes in total knee arthroplasty.
This was a retrospective cohort analysis of 112 patients undergoing primary total knee arthroplasty, wherein baseline demographics, resource utilization, and outcomes were compared by insurance type: Medicaid, Medicare, or private. At the time of surgery, Medicaid patients were younger (P<.0001) and had lower preoperative Knee Society Scores than Medicare and private patients (P=.0125). Medicaid postoperative scores were lower than those of private patients (P=.0223). The magnitude of benefit received by Medicaid patients was similar to Medicare and private patients. Medicaid patients had a higher number of cancelled (P=.01) and missed (P=.0022) appointments relative to Medicare and private patients. Medicaid patients also had shorter average follow-up periods compared to private patients (P=.0003). Access to care and socioeconomic factors may be responsible for these findings.
Department of Orthopaedics, Northwestern University, Chicago, Illinois.
Brett D
BD
Rosenthal
Department of Orthopaedics, Rush University, Chicago, Illinois; Central Dupage Hospital, Winfield, Illinois.
Jonah B
JB
Hulst
Department of Anesthesia, Rush University, Chicago, Illinois.
Mario
M
Moric
Department of Orthopaedics, Rush University, Chicago, Illinois; Central Dupage Hospital, Winfield, Illinois.
Brett R
BR
Levine
Department of Orthopaedics, Rush University, Chicago, Illinois; Central Dupage Hospital, Winfield, Illinois.
Scott M
SM
Sporer
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D015331:Cohort Studies; D006801:Humans; D007348:Insurance, Health; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D011897:Random Allocation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
Medicaid; insurance; outcome; primary; total knee arthroplasty