Arthroplasty Today (Mar 2019)

Payer type does not impact patient-reported outcomes after primary total knee arthroplasty

  • James E. Feng, MD,
  • Jonathan A. Gabor, BS,
  • Afshin A. Anoushiravani, MD,
  • William J. Long, MD, FRCSC,
  • Jonathan M. Vigdorchik, MD,
  • Patrick A. Meere, MD,
  • Richard Iorio, MD,
  • Ran Schwarzkopf, MD, MSc,
  • William Macaulay, MD

Journal volume & issue
Vol. 5, no. 1
pp. 113 – 118

Abstract

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Background: There is a paucity of literature assessing whether payer type has an impact on postoperative patient-reported outcomes (PROs) after total knee arthroplasty (TKA). The aim of this study was to comparatively evaluate TKA PROs among patients with commercial and Medicare insurance. Methods: We conducted a single-center, retrospective review of patients operated between January 2017 and March 2018. Knee Disability and Osteoarthritis Outcome Score Junior (KOOS-Jr) and Veterans RAND 12 Health Survey (VR-12) Physical Component (VR-12 PCS) and Mental Component (VR-12 MCS) PRO scores were collected prospectively at baseline and 12 weeks postoperatively via an electronic patient rehabilitation application. Univariable and multivariable linear regressions were utilized to assess the effects of patient insurance type on PRO. Results: In total, 193 TKA candidates had commercial (n = 91) or Medicare (n = 102) as their primary payer type. Demographic variables including age, gender, body mass index, and race varied significantly between the cohorts (P .05). Furthermore, ΔPRO scores from baseline to 12 weeks were also similar (P > .05). Conclusions: After adjusting for patient-specific variables, PROs are similar at baseline and 12 weeks postoperatively between commercial and Medicare cohorts. For TKA candidates with similar baseline demographics, surgeons can expect similar perioperative PROs regardless of insurance type. Keywords: Insurance, Patient-reported outcomes, Total knee arthroplasty, Medicare