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High Bundled Payment Costs Following Total Hip and Knee Arthroplasty in African Americans.
Chisari, Emanuele; Grosso, Matthew J; Kozaily, Elie; Nelson, Charles L; Sherman, Matthew B; Courtney, P Maxwell.
Afiliação
  • Chisari E; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Grosso MJ; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Kozaily E; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Nelson CL; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Sherman MB; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Courtney PM; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
J Arthroplasty ; 36(1): 19-23, 2021 01.
Article em En | MEDLINE | ID: mdl-32807564
BACKGROUND: Concerns exist that minorities who utilize more resources in an episode-of-care following total hip (THA) and knee arthroplasty (TKA) may face difficulties with access to quality arthroplasty care in bundled payment programs. The purpose of this study is to determine if African American patients undergoing TKA or THA have higher episode-of-care costs compared to Caucasian patients. METHODS: We queried Medicare claims data for a consecutive series of 7310 primary TKA and THA patients at our institution from 2015 to 2018. We compared patient demographics, comorbidities, readmissions, and 90-day episode-of-care costs between African American and Caucasian patients. A multivariate regression analysis was performed to identify the independent effect of race on episode-of-care costs. RESULTS: Compared to Caucasians, African Americans were younger, but had higher rates of pulmonary disease and diabetes. African American patients had increased rates of discharge to a rehabilitation facility (20% vs 13%, P < .001), with higher subacute rehabilitation ($1909 vs $1284, P < .001), home health ($819 vs $698, P = .022), post-acute care ($5656 vs $4961, P = .008), and overall 90-day episode-of-care costs ($19,457 vs $18,694, P = .001). When controlling for confounding comorbidities, African American race was associated with higher episode-of-care costs of $440 (P < .001). CONCLUSION: African American patients have increased episode-of-care costs following THA and TKA when compared to Caucasian patients, mainly due to increased rates of home health and rehabilitation utilization. Further study is needed to identify social variables that can help reduce post-acute care resources and prevent reduction in access to arthroplasty care in bundled payment models.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Aged / Humans País/Região como assunto: America do norte Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Aged / Humans País/Região como assunto: America do norte Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos