Medicare Reimbursement Attributable to Periprosthetic Joint Infection Following Primary Hip and Knee Arthroplasty.
This study estimated Medicare reimbursement attributable to periprosthetic joint infection (PJI) across the continuum of covered services four years following hip or knee arthroplasty. Using 2001-2008 Medicare claims data, total and annual attributable reimbursements were assessed using generalized linear regression, adjusting for potential confounders. Within one year following arthroplasty, 109 (1.04%) of 10,418 beneficiaries were diagnosed with PJI. Cumulative Medicare reimbursement in the PJI arm was 2.2-fold (1.9-2.6, P<.0001) or $53,470 ($39,575-$68,221) higher than that of the non-PJI arm. The largest difference in reimbursement occurred the first year (3.2-fold); differences persisted the second (2.3-fold) and third (1.9-fold) follow up years. PJI following hip or knee arthroplasty appears costly to Medicare, with cost traversing several years and health care service areas.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Sarah H
SH
Yi
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
James
J
Baggs
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Rollins School of Public Health, Emory University, Atlanta, Georgia.
Steven D
SD
Culler
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Sandra I
SI
Berríos-Torres
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
John A
JA
Jernigan
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics; D015897:Comorbidity; D005260:Female; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008297:Male; D006278:Medicare / Q000191:economics*; D016459:Prosthesis-Related Infections / Q000191:economics* / Q000209:etiology; D012189:Retrospective Studies; D014481:United States
Medicare reimbursement; arthroplasty; healthcare costs; healthcare-associated infection; periprosthetic joint infection