Orthopedics. 2024 Sep-Oct;47(5):283-288. doi: 10.3928/01477447-20240718-06. Epub 2024 Jul 29.
Patients undergoing total joint arthroplasty (TJA) may receive unexpected medical bills. Such "surprise" bills may cause financial hardship for patients, which prompted policymakers to pass the No Surprises Act. The purpose of this study was to determine the incidence of surprise bills for patients undergoing TJA and the effect of surprise billing on patient satisfaction.
This was a retrospective study of patients who underwent a primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a large multi-state institution. Patients completed a questionnaire regarding the incidence of surprise bills after their surgery, details of those bills, and how the bills affected their surgical satisfaction. Independent predictors for receiving a surprise bill were assessed through a multivariate regression analysis.
Twelve percent of participants received at least one surprise bill after their TJA. The most common surprise bill came from the surgical facility (48%), followed by anesthesia (36%). Multivariate logistic regression analysis identified older age and Black race to be independent predictors of surprise billing. Furthermore, surgery occurring after the No Surprises Act bill enforcement on January 1, 2022, was found to increase a patient's likelihood of receiving a surprise bill (=.039, effect size=0.18). Patients who received a surprise bill reported being significantly less satisfied with their surgery (=.002, effect size=0.45). Forty-nine percent of patients with a surprise bill felt their billing negatively affected their surgical satisfaction.
Surprise billing continues to occur after TJA and can negatively affect patient satisfaction. Although surgeons may be unable to limit the amount of bills patients receive postoperatively, increased communication and education regarding the perioperative billing process may prove to be beneficial for both patient satisfaction and the physician-patient relationship. [ 2024;47(5):283-288.].
接受全关节置换术（TJA）的患者可能会收到意料之外的医疗账单。这种“意外”账单可能会给患者带来经济困难，这促使政策制定者通过了《无意外法案》。本研究的目的是确定接受 TJA 的患者收到意外账单的发生率，以及意外计费对患者满意度的影响。
这是一项对在一家大型多州机构接受初次全髋关节置换术（THA）或全膝关节置换术（TKA）的患者进行的回顾性研究。患者在手术后完成了一份关于意外账单发生率、这些账单的详细信息以及账单如何影响他们手术满意度的问卷。通过多元回归分析评估了收到意外账单的独立预测因素。
12%的参与者在接受 TJA 后收到了至少一张意外账单。最常见的意外账单来自手术设施（48%），其次是麻醉（36%）。多元逻辑回归分析确定年龄较大和黑人种族是意外计费的独立预测因素。此外，发现《无意外法案》法案执行于 2022 年 1 月 1 日之后进行的手术会增加患者收到意外账单的可能性（=0.039，效应大小=0.18）。收到意外账单的患者表示对手术的满意度显著降低（=0.002，效应大小=0.45）。49%收到意外账单的患者认为他们的计费对手术满意度产生了负面影响。
TJA 后仍会发生意外计费，并可能对患者满意度产生负面影响。尽管外科医生可能无法限制患者术后收到的账单数量，但增加围手术期计费流程的沟通和教育可能对患者满意度和医患关系都有好处。[2024;47(5):283-288.]。
