Medicare Reimbursement Attributable to Periprosthetic Joint Infection Following Primary Hip and Knee Arthroplasty.

Sarah H Yi, James Baggs, Steven D Culler, Sandra I Berríos-Torres, John A Jernigan
Author Information
  1. Sarah H Yi: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
  2. James Baggs: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
  3. Steven D Culler: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Rollins School of Public Health, Emory University, Atlanta, Georgia.
  4. Sandra I Berríos-Torres: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
  5. John A Jernigan: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

Abstract

This study estimated Medicare reimbursement attributable to periprosthetic joint infection (PJI) across the continuum of covered services four years following hip or knee arthroplasty. Using 2001-2008 Medicare claims data, total and annual attributable reimbursements were assessed using generalized linear regression, adjusting for potential confounders. Within one year following arthroplasty, 109 (1.04%) of 10,418 beneficiaries were diagnosed with PJI. Cumulative Medicare reimbursement in the PJI arm was 2.2-fold (1.9-2.6, P<.0001) or $53,470 ($39,575-$68,221) higher than that of the non-PJI arm. The largest difference in reimbursement occurred the first year (3.2-fold); differences persisted the second (2.3-fold) and third (1.9-fold) follow up years. PJI following hip or knee arthroplasty appears costly to Medicare, with cost traversing several years and health care service areas.

Keywords

MeSH Term

Aged
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Comorbidity
Female
Humans
Insurance, Health, Reimbursement
Male
Medicare
Prosthesis-Related Infections
Retrospective Studies
United States

Word Cloud

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