Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type?
| Autor: | Sabesan V; Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA., Chatha K; Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA., Lima DJ; Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA., Yawman JP; Orlando Regional Medical Center, Group, Orlando, FL, USA., Khoury L; Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA., Routman H; Atlantis Orthopaedics, Palm Beach Gardens, FL, USA. |
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| Jazyk: | angličtina |
| Zdroj: | JSES international [JSES Int] 2021 Mar 09; Vol. 5 (5), pp. 900-904. Date of Electronic Publication: 2021 Mar 09 (Print Publication: 2021). |
| DOI: | 10.1016/j.jseint.2021.01.001 |
| Abstrakt: | Background: Although it has been shown that Medicare populations have a higher overall rate of complications than those with private insurances for large cohort total joint studies, there is limited information comparing patient-reported outcomes (PROs) among private insurance patients. The purpose of this study was to determine the impact of non-Medicaid insurance type on outcomes after shoulder arthroplasty. Methods: This retrospective case-controlled study included 203 patients who underwent shoulder arthroplasty from 2012 to 2017 by a single surgeon. Preoperative and postoperative PROs were collected and included the Simple Shoulder Test, the American Shoulder and Elbow Surgeons Shoulder Assessment Form, and the Constant Shoulder Score. Patients were categorized into groups based on insurer-preferred provider organization, health maintenance organization, Medicare, and Veterans Affairs Care program-and outcomes were compared between groups. Results: The 4 insurance provider groups were matched for body mass index, surgery type, and comorbidities ( P = .526). Preoperatively, no significant differences in PROs between groups were present except for the Constant Shoulder Score ( P = .029). All payer groups significantly improved from preoperative to postoperative PROs ( P ≤ .001). At the final follow-up, no significant difference in PROs between groups were seen (American Shoulder and Elbow Surgeons Shoulder mean 75.3 ± 20.9 [ P = .757], Simple Shoulder Test of 9.1 ± 2.9 [ P = .312], and Constant Shoulder Score of 65.0 ± 15.2 [ P = .526]). Conclusions: Our results suggest variations in insurance type did not significantly impact outcomes for our cohort of patients undergoing shoulder arthroplasty. Although variations in patient cohorts exist, patients regardless of insurance type and coverage variations can expect significant improvements in their function and pain after shoulder arthroplasty. (© 2021 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.) |
| Databáze: | MEDLINE |
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