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Medicaid Payer Status Is Associated With Increased 90-Day Resource Utilization, Reoperation, and Infection Following Aseptic Revision Total Hip Arthroplasty.

Publication ,  Journal Article
Sharma, A; Farley, KX; Schwartz, AM; Wilson, JM; Bradbury, TL; Guild, GN
Published in: Iowa Orthop J
2022

BACKGROUND: Prior literature has demonstrated increased resource utilization and perioperative complications in patients with a Medicaid payor status undergoing primary total hip and knee arthroplasty. This relationship has yet to be explored in patients undergoing revision total hip arthroplasty (rTHA). METHODS: The National Readmissions Database was queried from 2010 to 2015 for all patients undergoing aseptic rTHA. 90-day complication data were collected, and patients were separated into two cohorts based on insurance payor type: Medicaid and non-Medicaid. Patients were propensity score matched 2:1 on a number of comorbid and operative characteristics. The relationship between Medicaid payor status and postoperative outcomes was then assessed using binomial logistic regression analysis. RESULTS: 3,110 Medicaid patients were identified and matched to 6,175 non-Medicaid patients. Medicaid patients had increased odds of an early prosthetic joint infection (Odds Ratio [OR] 1.29, p=0.019), superficial surgical site infection (OR: 1.48, p=0.003), and early reoperation (OR: 1.18, p=0.045). Medicaid patients also experienced higher odds of readmissions, extended length of stay, non-home discharge status, and medical complications. Finally, the Medicaid cohort had a $3,332 (95% CI: 2,412-4,253, p<0.001) increased adjusted total cost of care when compared to the non-Medicaid cohort. CONCLUSION: This study identifies the Medicaid payor status as an independent risk factor for increased resource utilization, reoperation, and infection in the early postoperative period for patients undergoing rTHA. This relationship is likely due to an interplay of multiple variables, including socioeconomic status and access to care. Level of Evidence: IV.

Duke Scholars

Published In

Iowa Orthop J

EISSN

1555-1377

Publication Date

2022

Volume

42

Issue

2

Start / End Page

66 / 74

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Medicaid
  • Humans
  • Arthroplasty, Replacement, Knee
  • Arthroplasty, Replacement, Hip
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sharma, A., Farley, K. X., Schwartz, A. M., Wilson, J. M., Bradbury, T. L., & Guild, G. N. (2022). Medicaid Payer Status Is Associated With Increased 90-Day Resource Utilization, Reoperation, and Infection Following Aseptic Revision Total Hip Arthroplasty. Iowa Orthop J, 42(2), 66–74.
Sharma, Aman, Kevin X. Farley, Andrew M. Schwartz, Jacob M. Wilson, Thomas L. Bradbury, and George N. Guild. “Medicaid Payer Status Is Associated With Increased 90-Day Resource Utilization, Reoperation, and Infection Following Aseptic Revision Total Hip Arthroplasty.Iowa Orthop J 42, no. 2 (2022): 66–74.

Published In

Iowa Orthop J

EISSN

1555-1377

Publication Date

2022

Volume

42

Issue

2

Start / End Page

66 / 74

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Medicaid
  • Humans
  • Arthroplasty, Replacement, Knee
  • Arthroplasty, Replacement, Hip