This article is more than 5 years old. Information may no longer be current.
RSA performed nearly twice as often as hemiarthroplasty in Medicare patients
Click Here to Manage Email Alerts
In the Medicare population, researchers found reverse shoulder arthroplasty is performed at a frequency similar to total shoulder arthroplasty but nearly twice as often as shoulder hemiarthroplasty. Additionally, most reverse shoulder arthroplasties are performed by lower-volume surgeons, and the majority of surgeons perform more reverse shoulder arthroplasties than all other anatomic shoulder arthroplasties combined.
Patients 65 years and older from the 100% sample of the 2011 Medicare Part A were analyzed, with the researchers extracting data on demographic characteristics, diagnoses, provider information, reimbursements and lengths of hospital stays from the claims data. The researchers compared reverse shoulder arthroplasty (RSA) with total shoulder arthroplasty (TSA) and shoulder hemiarthroplasty (SHA). For each type of procedure, the researchers analyzed the hospital length-of-stay and hospital payments data from Medicare Part A and compared them with data from the Healthcare Cost and Utilization Project.
Results showed that of the 31,002 shoulder arthroplasty procedures studied, 37% were RSAs, 42% TSAs and 21% SHAs. Mean length of stay for RSA, TSA and SHA procedures was 2.6 days, 2.1 days and 3.5 days, respectively, and mean hospital payments for RSA, TSA and SHA were $12,625, $11,989 and $12,598, respectively.
According to the researchers, the primary diagnosis within the Medicare Part A database was osteoarthritis (OA) in 91% of TSAs, 37% of SHAs and 45% of RSAs. The primary diagnosis code recorded for 21% of RSAs was rotator cuff tear, whereas the primary diagnosis for 45% of SHAs was fracture / dislocation.
Most shoulder arthroplasties (57% RSAs, 65% TSAs and 97% SHAs) were performed by very low- or low-volume surgeons. Of the surgeons who performed more RSAs than TSAs and SHAs combined (25%), these surgeons also performed 70% of the RSAs studied, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Day reports he is an employee for xponent and receives financial and material support from Zimmer. Please see the full study for a list of all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts