ArticleThe Journal of rheumatology2020
Insurance Payer Type and Patient Income Are Associated with Outcomes after Total Shoulder Arthroplasty.
Article in The Journal of rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Low income and health literacy: a systematic scoping review.Archives of public health = Archives belges de sante publique · 2025Pooled it
- Determinants of prolonged hospitalization following shoulder arthroplasty: a systematic review of patient and health system factors.JSES reviews, reports, and techniques · 2026Review
- Preoperative Risk Factors for Opioid Use Predict Self-Reported Health and Function Up to 6 Months After Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2026Article
- Socioeconomic disadvantages and minority race correlate with worse outcomes following shoulder arthroplasty: a systematic review.JSES reviews, reports, and techniques · 2025Article
- Patient Health Care Disparities in Shoulder Arthroplasty.Current reviews in musculoskeletal medicine · 2025Review
- Patient race and ethnicity are associated with higher unplanned 90-day emergency department visits and readmissions but not 10-year all-cause complications or reoperations: a matched cohort analysis of primary shoulder arthroplasties.JSES reviews, reports, and techniques · 2025Article
- Medicare and Medicaid patients undergoing total joint arthroplasty have more complications and healthcare utilization than privately insured patients.Journal of orthopaedics · 2025Article
- Characteristics of employment history and self-perceived barriers to healthcare access.European journal of public health · 2023Article
- Identification of Independent Predictors of Increased 90-Day Complication and Revision Rates Following Total Elbow Arthroplasty.Journal of shoulder and elbow arthroplasty · 2023Article
- Socioeconomic factors affecting outcomes in total knee and hip arthroplasty: a systematic review on healthcare disparities.Arthroplasty (London, England) · 2022Review
- The Effect of Additional Private Health Insurance on Mortality in the Context of Universal Public Health Insurance.International journal of environmental research and public health · 2021Article
- Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States: Trends from 2011 to 2017.JB & JS open accessArticle
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2 authors.
Funding
Abstract
objectiveTo assess the independent association of insurance and patient income with total shoulder arthroplasty (TSA) outcomes.
methodsWe used the 1998-2014 US National Inpatient Sample. We used multivariable-adjusted logistic regression to examine whether insurance type and the patient's median household income (based on postal code) were independently associated with healthcare use (discharge destination, hospital stay duration, total hospital charges) and in-hospital complications post-TSA based on the diagnostic codes (fracture, infection, transfusion, or revision surgery). We calculated the OR and 95% CI.
resultsAmong the 349,046 projected TSA hospitalizations, the mean age was 68.6 years, 54% were female, and 73% white. Compared to private insurance, Medicaid and Medicare (government insurance) users were associated with significantly higher adjusted OR (95% CI) of (1) discharge to a rehabilitation facility, 2.16 (1.72-2.70) and 2.27 (2.04-2.52); (2) hospital stay > 2 days, 1.65 (1.45-1.87) and 1.60 (1.52-1.69); and (3) transfusion, 1.35 (1.05-1.75) and 1.39 (1.24-1.56), respectively. Medicaid was associated with a higher risk of fracture [1.74 (1.07-2.84)] and Medicare user with a higher risk of infection [2.63 (1.24-5.57)]; neither were associated with revision. Compared to the highest income quartile, the lowest income quartile was significantly associated with (OR, 95% CI): (1) discharge to a rehabilitation facility (0.89, 0.83-0.96); (2) hospital stay > 2 days (0.84, 0.80-0.89); (3) hospital charges above the median (1.19, 1.14-1.25); (4) transfusion (0.73, 0.66-0.81); and (5) revision (0.49, 0.30-0.80), but not infection or fracture.
conclusionThis information can help to risk-stratify patients post-TSA. Future assessments of modifiable mediators of these complications are needed.
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