Do Patient Point of Entry and Medicaid Status Affect Quality Outcomes Following Total Knee Arthroplasty?

The Journal of Arthroplasty
James E FengRan Schwarzkopf

Abstract

The effect of surgeon practice and patient care setting have not been studied in the Medicaid population undergoing total knee arthroplasty (TKA). This study aims to evaluate whether point of entry and Medicaid status affect outcomes following TKA. The electronic medical record at our urban, academic, tertiary care hospital system was retrospectively reviewed for all primary, unilateral TKA during January 2016 and January 2018. Outpatient visits within the 6-month preoperative period categorized TKA recipients as either Hospital Ambulatory Clinic Centers patients with Medicaid insurance or private office patients with non-Medicaid insurers. There were 174 Medicaid patients and 317 non-Medicaid patients for 491 total patients. Medicaid patients were significantly younger (62.6 ± 1.6 vs 65.4 ± 1.1 years, P < .01), of "other' ethnicity (43.1% vs 25.6%, P < .01), and to be a current smoker (9.3% vs 6.6%, P = .02). There was no difference in gender, body mass index, and American Society of Anesthesiologists score. After controlling for patient factors, the Medicaid effect was insignificant for surgical time (exponentiated β 0.93, 95% confidence interval [CI] 0.86-1.01, P = .076) and facility discharge (odds ratio 1.58, 95% CI 0.71-3...Continue Reading

References

Oct 1, 1996·Clinical Orthopaedics and Related Research·P J KumarK Baldwin
Oct 22, 2003·The Journal of Ambulatory Care Management·Andrew B BindmanKevin Grumbach
Oct 27, 2006·Clinical Orthopaedics and Related Research·Frank L WalterDavid C Markel
Sep 13, 2007·Health Affairs·Nakela L CookBruce E Landon
Sep 9, 2008·The Journal of Arthroplasty·Adrian Hinman, Kevin J Bozic
Mar 23, 2011·Annals of the Royal College of Surgeons of England·Samantha JonesDeiary Kader
Apr 7, 2012·Orthopaedics & Traumatology, Surgery & Research : OTSR·S-W HuangY-H Chou
Nov 13, 2012·The Journal of Arthroplasty·Barthelemy LiabaudJeffrey A Geller
Jan 11, 2014·The Journal of Arthroplasty·Ran SchwarzkopfDana Mukamel
Apr 29, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Luis M LozanoMisericordia Basora
Nov 8, 2014·The Journal of Bone and Joint Surgery. American Volume·James A BrowneMichele R D'Apuzzo
Apr 12, 2015·International Orthopaedics·Lawrence S MoultonTony Smith
Dec 22, 2015·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Nina M C MathijssenGerjon Hannink
Feb 14, 2017·Journal of Shoulder and Elbow Surgery·Xinning LiAsheesh Bedi
Jul 22, 2017·The Surgical Clinics of North America·Todd C CrawfordJuan A Sanchez
Sep 16, 2017·Arthroplasty Today·Roy H Lan, Atul F Kamath
Jan 3, 2019·Orthopedics·David S CasperChristopher K Kepler

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Citations

Oct 10, 2021·Current Reviews in Musculoskeletal Medicine·Danielle S ChunLinda I Suleiman

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