7 key points on Medicaid total joint replacement patients

Orthopedic Sports Medicine

Medicaid patients are more likely to have in-hospital morbidity and use more resources than patients with other payers who undergo total joint arthroplasty, according to an article published in the Journal of Bone and Joint Surgery.

Researchers examined the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database for patients who underwent primary hip and knee arthroplasty from 2002 to 2011. Medicaid patients were matched with non-Medicaid patient to compare complications, cost and hospital length of stay.

 

There were 191,911 patients included in the study who had Medicaid payer status and 107,335 of the Medicaid patients were matched one-to-one with non-Medicaid patients for the analysis.

 

The researchers found:

 

1. Medicaid patients were more likely to have postoperative in-hospital infections. The odds ratio was 1.3 to 2.1.

 

2. Medicaid patients were also more likely to have wound dehiscence with an odds ratio of 1.4 to 3.4.

 

3. Medicaid patients were more likely to develop a hematoma or seroma as well. The odds ratio was 1.2 to 1.4.

 

4. There was a lower cardiac complications risk for Medicaid patients, with an odds ratio at 0.6 to 0.9.

 

5. Hospital length of stay was longer for Medicaid patients.

 

6. Total costs were higher for Medicaid patients.

 

7. Medicaid patients were more often discharged to an inpatient facility.

 

"Additional work is needed to understand the complex interplay between socioeconomic status and outcomes, to ensure appropriate resources are allocated to main access for this patient population, and to develop appropriate risk stratification," concluded the study authors.

 

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