Department of Orthopaedics, Northwestern University, Chicago, Illinois.
Department of Orthopaedics, Rush University, Chicago, Illinois; Central Dupage Hospital, Winfield, Illinois.
J Arthroplasty. 2014 Feb;29(2):295-8. doi: 10.1016/j.arth.2013.06.010. Epub 2013 Aug 6.
This was a retrospective cohort analysis of 112 patients undergoing primary total knee arthroplasty, wherein baseline demographics, resource utilization, and outcomes were compared by insurance type: Medicaid, Medicare, or private. At the time of surgery, Medicaid patients were younger (P<.0001) and had lower preoperative Knee Society Scores than Medicare and private patients (P=.0125). Medicaid postoperative scores were lower than those of private patients (P=.0223). The magnitude of benefit received by Medicaid patients was similar to Medicare and private patients. Medicaid patients had a higher number of cancelled (P=.01) and missed (P=.0022) appointments relative to Medicare and private patients. Medicaid patients also had shorter average follow-up periods compared to private patients (P=.0003). Access to care and socioeconomic factors may be responsible for these findings.
这是一项回顾性队列分析，共纳入 112 例行初次全膝关节置换术的患者，根据保险类型（医疗补助、医疗保险或私人保险）比较了基线人口统计学、资源利用和结局。手术时，医疗补助患者比医疗保险和私人保险患者更年轻（P<.0001），术前膝关节协会评分也更低（P=.0125）。医疗补助患者的术后评分低于私人患者（P=.0223）。医疗补助患者获得的获益程度与医疗保险和私人保险患者相似。与医疗保险和私人保险患者相比，医疗补助患者取消（P=.01）和错过（P=.0022）预约的次数更多。医疗补助患者的平均随访时间也比私人患者短（P=.0003）。获得医疗服务的机会和社会经济因素可能是造成这些结果的原因。
