J Comp Eff Res. 2019 Oct; 8(14): 1213–1228.

Medicaid insurance status predicts postoperative mortality after total knee arthroplasty in state inpatient databases

Stephan R Maman,*,1 Michael H Andreae,1 Licia K Gaber-Baylis,2 Zachary A Turnbull,3 and Robert S White3
Knee

Aim:

Medicaid versus private primary insurance status may predict in-hospital mortality and morbidity after total knee arthroplasty (TKA).

Materials & methods:

Regression models were used to test our hypothesis in patients in the State Inpatient Database (SID) from five states who underwent primary TKA from January 2007 to December 2014.

Results:

Medicaid patients had greater odds of in-hospital mortality (odds ratio [OR]: 1.73; 95% CI: 1.01–2.95), greater odds of any postoperative complications (OR: 1.25; 95% CI: 1.18–1.33), experience longer lengths of stay (OR: 1.09; 95% CI: 1.08–1.10) and higher total charges (OR: 1.03; 95% CI: 1.02–1.04).

Conclusion:

Medicaid insurance status is associated with higher in-hospital mortality and morbidity in patients after TKA compared with private insurance.

Keywords: : disparity, insurance, Medicaid, outcomes, perioperative, total knee arthroplasty

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