Who is Completing Patient-Reported Outcome Measures following Total Hip Arthroplasty? An Investigation of Completion Characteristics to Inform the Age of Mandatory Reporting Rates.

BACKGROUND

The Centers for Medicare and Medicaid Services has mandated at least 50% institutional compliance of patient-reported outcome-based performance measures (PRO-PMs) for Medicare fee-for-service patients undergoing inpatient, elective total joint arthroplasty. The purpose of this study was to evaluate characteristics of patients undergoing primary total hip arthroplasty to identify risk factors for patient-reported outcome measures (PROMs) noncompletion using the Hip Dysfunction and Osteoarthritis Joint Replacement Outcome Score as a marker PROM.

METHODS

A retrospective review was performed of patients undergoing primary total hip arthroplasty at a single large academic center between January 2013 and August 2020. Demographics, operative variables, hospital outcomes, and PROMs were compared between patients achieving and not achieving PRO-PM requirements and multivariable analysis was performed.

RESULTS

A total of 5691 patients were included; 2547 patients did not complete either PROM, 2201 completed the preoperative PROM within 90 days of surgery, and 943 completed the PROM preoperatively and at 365 ± 60 days postoperatively. Demographics and outcomes between groups varied; patients not completing the PROM more often had a length of stay >48 hours ( < .001) and any complication (q = 0.07); these associations remained significant with adjusted multivariable analyses.

CONCLUSIONS

PRO-PM completion is necessary for compliance with the new Centers for Medicare and Medicaid Services mandate. We report on the characteristics of patients completing and not completing a marker PROM as well as risk factors for noncompletion from the era before this mandate, before substantial efforts were undertaken to increase response rate, to provide an organic overview of the patients at risk for noncompletion to guide further initiatives.