Medicare, Medicaid & uninsured patients experience higher complication rate following shoulder replacements — 6 key points

Written by Megan Wood | February 13, 2017 | Print  |

A Boston University Medical Center study investigated whether patients undergoing shoulder replacement surgery experienced varied complication rates dependent on their insurance.

The researchers gathered data from The Healthcare Cost and Utilization Project Nationwide Inpatient Sample, studying more than 100,000 cases of patients receiving shoulder arthroplasty procedures. Of those cases, 68,578 patients had Medicare, 27,159 had private insurance, 3,544 had Medicaid or were uninsured and 4,009 had other insurance.


Journal of Shoulder and Elbow Surgery published the study.


Here are six key points:


1. The study found the overall perioperative medical and surgical complication rate to be 17.2 percent with the mortality rate hitting 0.2 percent.


2. Those patients with Medicare (20.3 percent) and Medicaid or no insurance (16.9 percent) experienced a higher rate of medical, surgical and overall complications compared to those patients with private insurance (10.5 percent), however.


3. The researchers found no significant differences in complication rates between Medicare and Medicaid/uninsured patients.


4. The researchers postulated that these higher complication rates may be associated with the patients' lack of access to preoperative and postoperative care because of education level or socioeconomic status.


5. Patients with Medicaid or no insurance may also not have access to high-volume surgeons, the researchers suggested. In contrast, the study indicated patients with private insurance were more likely to undergo surgery at high-volume hospitals.


6. Future research should zone in on the clinical and socioeconomic factors that impact the disparities in complication rates, the researchers concluded.


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