Affordable Access

deepdyve-link
Publisher Website

Does Medicaid payer status affect patient's shoulder outcomes after shoulder arthroplasty?

Authors
  • Sabesan, V J1
  • Lima, D J L2
  • Goss, L3
  • Gauger, M4
  • Whaley, J D5
  • Ghisa, C3
  • Malone, D L2
  • 1 Department of Orthopaedic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA. [email protected]
  • 2 Department of Orthopaedic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
  • 3 Department of Orthopaedic Surgery, Wayne State University School of Medicine, Troy, MI, USA.
  • 4 Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, USA.
  • 5 Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, MI, USA.
Type
Published Article
Journal
Musculoskeletal surgery
Publication Date
Apr 01, 2021
Volume
105
Issue
1
Pages
43–47
Identifiers
DOI: 10.1007/s12306-019-00627-w
PMID: 31712979
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Low socioeconomic status and Medicaid insurance as a primary payer have been shown to influence resource utilization and risk-adjusted outcomes for total joint arthroplasty. The purpose of this study was to assess the effects of Medicaid primary payer status on outcomes following shoulder arthroplasty (SA). A retrospective review of shoulder surgery patients was undertaken to identify a matched cohort of 51 patients who underwent SA and were stratified based on insurance type into two cohorts: 28 Medicaid (M) patients and 23 non-Medicaid (NM) patients. Baseline demographics, resource utilization, and outcomes were compared as well as pre-and-postoperative patient-reported outcomes (PRO) and functional scores. PRO scores included the American shoulder and elbow surgeons score (ASES), the Penn shoulder score (PSS), and the subjective shoulder value (SSV). There were no statistically significant differences in demographics, comorbidities, or preoperative baseline scores between the cohorts, except for age (M: 55.3 years; NM: 67.5 years; p ≤ 0.001) and smoking status (M: 13 patients; NM: 4 patients; p = 0.029). Medicaid patients showed a slightly higher rate of missed follow-ups (M: 1.1 vs. NM: 0.9; p = 0.370). All Medicaid and non-Medicaid patients experienced significant improvement on PRO scores and active forward flexion. Medicaid patients demonstrated equivalent final postoperative scores for ASES (M: 65; NM: 57; p = 0.454), PSS (M: 63; NM: 51; p = 0.242), SSV (M: 70; NM: 69; p = 1.0) and range of motion measurements. Overall results suggest that Medicaid patients can expect significant improvement after SA and the same level of PRO's compared to non-Medicaid-insured population. Level III, Retrospective Comparative Design, Treatment Study.

Report this publication

Statistics

Seen <100 times