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Medicare Insurance Is Associated with Reduced Hip Arthroscopy Patient-Reported Outcome Measures
Maxwell Harrell1, Clay Rahaman1, Dev Dayal1
1University of Alabama at Birmingham, Birmingham.
Insights
Patients with Medicare insurance reported significantly lower outcomes after hip arthroscopy compared to those with commercial insurance. Further research is needed to understand demographic influences on these results.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Patient-Reported Outcomes
Background:
- Hip arthroscopy (HA) is a common procedure for hip conditions.
- Patient-reported outcome measures (PROMs) are crucial for evaluating HA success.
- Insurance type may influence patient outcomes after HA.
Purpose of the Study:
- To compare PROMs after HA between patients with commercial insurance and those with government-provided insurance (Medicare, Medicaid, VA/TRICARE).
- To identify potential disparities in outcomes based on insurance status.
Main Methods:
- Retrospective cohort study of 84 patients (≥18 years) undergoing HA.
- Patients categorized into commercial, Medicare, Medicaid, or VA/TRICARE insurance groups.
- PROMs (mHHS, HOS-ADL, HOS-Sports, NHAS) collected at ≥1-year follow-up.
Main Results:
- Medicare patients were significantly older than commercial insurance patients (P=0.002).
- Patients with Medicare showed significantly lower PROMs across all measures compared to commercial insurance.
- No significant PROM differences were observed between commercial insurance and Medicaid or VA/TRICARE groups.
Conclusions:
- Medicare patients experienced significantly lower PROMs after hip arthroscopy compared to commercially insured patients.
- Age and other demographic factors may contribute to these observed differences.
- Further investigation is required to elucidate the relationship between insurance type, demographics, and HA outcomes.
Objective:
The purpose of this study was to evaluate the difference in patient-reported outcome measures (PROMs) after hip arthroscopy (HA) among patients with commercial insurance as compared with those with government-provided insurance, such as Medicare, Medicaid, and TRICARE or Veterans Affairs (VA).
Methods:
This retrospective cohort study queried an institutional database for patients 18 years or older who underwent HA in the prior 10 years. Patients were excluded if they did not have at least 1-year postoperative PROMs, were self-pay, had Workers' Compensation insurance, were uninsured, or had a hip arthroplasty after their arthroscopy. Patients were divided into four groups: commercial insurance, Medicare, Medicaid, and VA or TRICARE. Demographic information and PROMs were collected at a minimum of 1-year follow-up, including the modified Harris Hip Score, Hip Outcome Score (HOS)-Activities of Daily Living, HOS-Sports, and Non-Arthritic Hip Score.
Results:
This study included 84 patients, 31 of whom had government-provided insurance, 53 had commercial insurance; 11 had Medicaid, six had Medicare, and 14 had VA or TRICARE coverage. Medicare patients were significantly older than those with commercial insurance (P=0.002). Patients with Medicaid (n=6) had significantly lower PROMs than those with commercial insurance (n=53). Significant differences were found in the modified Harris Hip Score (Medicare 50.8±15.1, commercial 69.1±15.8; P=0.015), HOS-Activities of Daily Living (Medicare 59.5±15.3, commercial 77.8±18.2; P=0.021), HOS-Sports (Medicare 31.9±16.1, commercial 69.7±28.0; P=0.005), and Non-Arthritic Hip Score (Medicare 55.8±18.0, commercial 77.6±19.5; P=0.020). No difference in PROMs were noted between those with commercial insurance and those with Medicaid or VA/TRICARE coverage.
Conclusions:
This study demonstrated that those with Medicare insurance had significantly lower PROMs than those with commercial insurance. It is unclear, however, to what extent this finding reflects underlying demographic differences such as age. Further research is needed to clarify this relationship.
