Insurance status is not a predictor of rotator cuff tear magnitude.
Access to care
Insurance status
Medicaid
Medicare
Private insurance
Rotator cuff tear
Journal
JSES international
ISSN: 2666-6383
Titre abrégé: JSES Int
Pays: United States
ID NLM: 101763461
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
entrez:
9
9
2022
pubmed:
10
9
2022
medline:
10
9
2022
Statut:
epublish
Résumé
Rotator cuff tear (RCT) chronicity is an important factor in considering treatment options and outcomes for surgical repair. Many factors may contribute to delayed treatment, including timely access to care due to insurance status. The purpose of this study was to evaluate the relationship between the magnitude of RCT on presentation and insurance status. We hypothesize that publicly insured patients will have a greater incidence of chronic RCTs and shoulder pathology on initial presentation. Retrospective chart review of patients undergoing RCT repair at an academic tertiary care institution from 2005 to 2019. Demographic data, including age, race, sex, and insurance carrier, were collected. Insurance carriers were categorized into public (Medicare and Medicaid) or private insurance coverage. Individual magnetic resonance imagings were then reviewed by a board-certified musculoskeletal radiologist for supraspinatus (SS), infraspinatus (IS), subscapularis, and biceps tendon tears, as well as acromioclavicular arthritis. In addition, rotator cuff atrophy was evaluated by the scapular ratio. Univariate analysis of variance and logistic regression analyses were used to compare demographics and rotator cuff pathology between those with Medicaid and Medicare, as well as between publicly and privately insured patients. Of the 492 patients in this study, 192 had private insurance, and 300 had public insurance (Medicaid: 50 and Medicare: 250). Insurance status was not found to be associated with differences in RCTs between Medicare and Medicaid patients. Those with Medicaid or Medicare (public), presented more frequently with SS or IS atrophy (SS atrophy, Patients with private and public insurance tend to present with similar chronicity and magnitude of RCTs. Insurance status does not appear to influence timely access to surgical care for patients with RCTs at an academic medical center.
Sections du résumé
Background
UNASSIGNED
Rotator cuff tear (RCT) chronicity is an important factor in considering treatment options and outcomes for surgical repair. Many factors may contribute to delayed treatment, including timely access to care due to insurance status. The purpose of this study was to evaluate the relationship between the magnitude of RCT on presentation and insurance status. We hypothesize that publicly insured patients will have a greater incidence of chronic RCTs and shoulder pathology on initial presentation.
Methods
UNASSIGNED
Retrospective chart review of patients undergoing RCT repair at an academic tertiary care institution from 2005 to 2019. Demographic data, including age, race, sex, and insurance carrier, were collected. Insurance carriers were categorized into public (Medicare and Medicaid) or private insurance coverage. Individual magnetic resonance imagings were then reviewed by a board-certified musculoskeletal radiologist for supraspinatus (SS), infraspinatus (IS), subscapularis, and biceps tendon tears, as well as acromioclavicular arthritis. In addition, rotator cuff atrophy was evaluated by the scapular ratio. Univariate analysis of variance and logistic regression analyses were used to compare demographics and rotator cuff pathology between those with Medicaid and Medicare, as well as between publicly and privately insured patients.
Results
UNASSIGNED
Of the 492 patients in this study, 192 had private insurance, and 300 had public insurance (Medicaid: 50 and Medicare: 250). Insurance status was not found to be associated with differences in RCTs between Medicare and Medicaid patients. Those with Medicaid or Medicare (public), presented more frequently with SS or IS atrophy (SS atrophy,
Conclusions
UNASSIGNED
Patients with private and public insurance tend to present with similar chronicity and magnitude of RCTs. Insurance status does not appear to influence timely access to surgical care for patients with RCTs at an academic medical center.
Identifiants
pubmed: 36081697
doi: 10.1016/j.jseint.2022.05.014
pii: S2666-6383(22)00128-1
pmc: PMC9446165
doi:
Types de publication
Journal Article
Langues
eng
Pagination
815-819Informations de copyright
© 2022 The Authors.
Références
J Shoulder Elbow Surg. 2014 Dec;23(12):1913-1921
pubmed: 25441568
J Orthop Res. 2017 Dec;35(12):2808-2814
pubmed: 28470887
Orthop J Sports Med. 2020 Oct 19;8(10):2325967120959330
pubmed: 33178878
Orthop J Sports Med. 2018 Jan 16;6(1):2325967117750104
pubmed: 29372169
Orthop J Sports Med. 2021 Jan 22;9(1):2325967120979989
pubmed: 33553460
J Shoulder Elbow Surg. 2017 Aug;26(8):1423-1431
pubmed: 28190669
J Bone Joint Surg Am. 2019 Nov 20;101(22):e121
pubmed: 31764373
J Pediatr Orthop. 2015 Jan;35(1):39-42
pubmed: 24978118
J Arthroplasty. 2014 Jun;29(6):1083-6.e1
pubmed: 24405615
Geriatr Orthop Surg Rehabil. 2015 Sep;6(3):220-4
pubmed: 26328240
Med Care. 2018 Feb;56(2):186-192
pubmed: 29271819
Musculoskelet Surg. 2013 Jun;97 Suppl 1:69-72
pubmed: 23588834
Spine (Phila Pa 1976). 2014 Sep 15;39(20):1707-13
pubmed: 24983931
J Am Acad Orthop Surg. 2020 Feb 15;28(4):e158-e163
pubmed: 31365357
Radiographics. 2006 Jul-Aug;26(4):1045-65
pubmed: 16844931
J Shoulder Elbow Surg. 2019 Nov;28(11):2079-2083
pubmed: 31521525
J Shoulder Elbow Surg. 2013 Nov;22(11):1537-46
pubmed: 23642348
Orthop J Sports Med. 2020 Jul 31;8(7):2325967120933696
pubmed: 32782900
World J Orthop. 2015 Mar 18;6(2):211-20
pubmed: 25793161
Orthop J Sports Med. 2017 Jul 07;5(7):2325967117714140
pubmed: 28812034
Adv Orthop. 2015;2015:458786
pubmed: 26171251
J Orthop Res. 2019 Jan;37(1):211-219
pubmed: 30325061
Milbank Q. 1993;71(2):279-322
pubmed: 8510603
J Bone Joint Surg Am. 2001 Jan;83(1):71-7
pubmed: 11205861
West J Emerg Med. 2020 Aug 20;21(5):1242-1248
pubmed: 32970581
J Surg Res. 2017 Jan;207:123-130
pubmed: 27979467
Am J Orthop (Belle Mead NJ). 2015 Nov;44(11):E454-7
pubmed: 26566561
Front Bioeng Biotechnol. 2021 Jul 05;9:691450
pubmed: 34291041
Curr Rev Musculoskelet Med. 2020 Oct;13(5):572-583
pubmed: 32681307
Orthop J Sports Med. 2019 Oct 03;7(10):2325967119875079
pubmed: 31620487
J Bone Joint Surg Am. 2013 Nov 20;95(22):1993-2000
pubmed: 24257656
J Pediatr Orthop. 2006 May-Jun;26(3):400-4
pubmed: 16670556
Orthopedics. 2020 Nov 1;43(6):340-344
pubmed: 33002182
J Bone Joint Surg Am. 2012 Dec 19;94(24):e183
pubmed: 23318622
Am J Sports Med. 2015 Feb;43(2):491-500
pubmed: 24753240
AJR Am J Roentgenol. 2003 Mar;180(3):633-9
pubmed: 12591665
J Bone Joint Surg Am. 2010 Apr;92(4):829-39
pubmed: 20360505
J Bone Joint Surg Br. 1995 Mar;77(2):296-8
pubmed: 7706351
J Hand Surg Am. 2020 Jan;45(1):26-32
pubmed: 31610906