Age and Frailty Influence Hip and Knee Arthroplasty Reimbursement in a Bundled Payment Care Improvement Initiative

The Journal of Arthroplasty
Andrew M PepperWilliam J Long

Abstract

The Bundled Payment Care Improvement (BPCI) initiative aims to improve quality of patient care while mitigating cost. How patient age and frailty affect reimbursement after hip and knee total joint arthroplasty (TJA) is not known. This study evaluates if patient age and frailty affect cost of care. A retrospective review of prospectively collected data of 1821 patients undergoing TJA at our institution under the BPCI initiative was performed from 2013 to 2016. We recorded demographics for patients and calculated their modified frailty index (mFI). Cost of care was obtained for each patient. Statistical analyses included t-test and analysis of variance to evaluate age and frailty as independent categorical variables. Beta coefficients were utilized to evaluate age as a continuous variable. Multivariate linear regression models evaluated age and frailty's combined contribution to cost. Age was evaluated as a categorical variable, with the median age of our sample population the categorical cutoff. Age ≥72 years and increasing mFI score were associated with statistically significant increased cost. Increasing age demonstrated a statistically significant increase in cost of 0.68% per incremental age increase. Multivariate evaluatio...Continue Reading

Citations

Jul 15, 2020·Clinical Orthopaedics and Related Research·Nipun SodhiMartin W Roche
Sep 2, 2020·The Journal of Bone and Joint Surgery. American Volume·William P PetersenWilliam J Long
Oct 8, 2020·The Journal of Bone and Joint Surgery. American Volume·William P PetersenWilliam J Long
Dec 3, 2020·The Journal of Bone and Joint Surgery. American Volume·Michael J Taunton
Jul 24, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Yale A FillinghamP Maxwell Courtney
May 6, 2021·Journal of General Internal Medicine·Jonathan D WolfeKaren E Joynt Maddox

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