Outpatient versus inpatient total shoulder arthroplasty: A cost and outcome comparison in a comorbidity matched analysis

Andrew Carbone; Alexander J. Vervaecke; Ivan B. Ye; Akshar V. Patel; Bradford O. Parsons; Leesa M. Galatz; Jashvant Poeran; Paul Cagle

doi:10.1016/j.jor.2021.11.016

Outpatient versus inpatient total shoulder arthroplasty: A cost and outcome comparison in a comorbidity matched analysis

Andrew Carbone, Alexander J. Vervaecke, Ivan B. Ye, Akshar V. Patel, Bradford O. Parsons, Leesa M. Galatz, Jashvant Poeran, Paul Cagle

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background: Previous studies comparing total and reverse shoulder arthroplasty (TSA/RSA) are subject to surgeon selection bias. This study objective is to compare the outcomes and cost of outpatient TSA/RSA to inpatient TSA/RSA. Methods: 108,889 elective inpatient and outpatient TSA/RSA from Medicare claims data (2016–2018). 90-day readmission and total 90-day costs were compared following propensity score matching. Results: Younger and healthier patients are receiving outpatient TSA/RSA. Outpatient TSA/RSA was associated with fewer 90-day readmissions (OR 0.48 CI 0.38–0.59, p < 0.001) and lower 90-day costs (−20.1% CI -19.1%; −21.1%, p < 0.001). Conclusions: Outpatient TSA/RSA surgery offers lower complication rates and total costs. Level of evidence: III.

Original language	English
Pages (from-to)	126-133
Number of pages	8
Journal	Journal of Orthopaedics
Volume	28
DOIs	https://doi.org/10.1016/j.jor.2021.11.016
State	Published - 1 Nov 2021

Keywords

Ambulatory surgery center
Cost analysis
Outpatient
Readmission
Reverse shoulder arthroplasty
Total shoulder arthroplasty

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10.1016/j.jor.2021.11.016

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@article{2be6572891544ca9b8ae0255bd83c034,

title = "Outpatient versus inpatient total shoulder arthroplasty: A cost and outcome comparison in a comorbidity matched analysis",

abstract = "Background: Previous studies comparing total and reverse shoulder arthroplasty (TSA/RSA) are subject to surgeon selection bias. This study objective is to compare the outcomes and cost of outpatient TSA/RSA to inpatient TSA/RSA. Methods: 108,889 elective inpatient and outpatient TSA/RSA from Medicare claims data (2016–2018). 90-day readmission and total 90-day costs were compared following propensity score matching. Results: Younger and healthier patients are receiving outpatient TSA/RSA. Outpatient TSA/RSA was associated with fewer 90-day readmissions (OR 0.48 CI 0.38–0.59, p < 0.001) and lower 90-day costs (−20.1% CI -19.1%; −21.1%, p < 0.001). Conclusions: Outpatient TSA/RSA surgery offers lower complication rates and total costs. Level of evidence: III.",

keywords = "Ambulatory surgery center, Cost analysis, Outpatient, Readmission, Reverse shoulder arthroplasty, Total shoulder arthroplasty",

author = "Andrew Carbone and Vervaecke, {Alexander J.} and Ye, {Ivan B.} and Patel, {Akshar V.} and Parsons, {Bradford O.} and Galatz, {Leesa M.} and Jashvant Poeran and Paul Cagle",

note = "Publisher Copyright: {\textcopyright} 2021 Professor P K Surendran Memorial Education Foundation",

year = "2021",

month = nov,

day = "1",

doi = "10.1016/j.jor.2021.11.016",

language = "English",

volume = "28",

pages = "126--133",

journal = "Journal of Orthopaedics",

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TY - JOUR

T1 - Outpatient versus inpatient total shoulder arthroplasty

T2 - A cost and outcome comparison in a comorbidity matched analysis

AU - Carbone, Andrew

AU - Vervaecke, Alexander J.

AU - Ye, Ivan B.

AU - Patel, Akshar V.

AU - Parsons, Bradford O.

AU - Galatz, Leesa M.

AU - Poeran, Jashvant

AU - Cagle, Paul

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Background: Previous studies comparing total and reverse shoulder arthroplasty (TSA/RSA) are subject to surgeon selection bias. This study objective is to compare the outcomes and cost of outpatient TSA/RSA to inpatient TSA/RSA. Methods: 108,889 elective inpatient and outpatient TSA/RSA from Medicare claims data (2016–2018). 90-day readmission and total 90-day costs were compared following propensity score matching. Results: Younger and healthier patients are receiving outpatient TSA/RSA. Outpatient TSA/RSA was associated with fewer 90-day readmissions (OR 0.48 CI 0.38–0.59, p < 0.001) and lower 90-day costs (−20.1% CI -19.1%; −21.1%, p < 0.001). Conclusions: Outpatient TSA/RSA surgery offers lower complication rates and total costs. Level of evidence: III.

AB - Background: Previous studies comparing total and reverse shoulder arthroplasty (TSA/RSA) are subject to surgeon selection bias. This study objective is to compare the outcomes and cost of outpatient TSA/RSA to inpatient TSA/RSA. Methods: 108,889 elective inpatient and outpatient TSA/RSA from Medicare claims data (2016–2018). 90-day readmission and total 90-day costs were compared following propensity score matching. Results: Younger and healthier patients are receiving outpatient TSA/RSA. Outpatient TSA/RSA was associated with fewer 90-day readmissions (OR 0.48 CI 0.38–0.59, p < 0.001) and lower 90-day costs (−20.1% CI -19.1%; −21.1%, p < 0.001). Conclusions: Outpatient TSA/RSA surgery offers lower complication rates and total costs. Level of evidence: III.

KW - Ambulatory surgery center

KW - Cost analysis

KW - Outpatient

KW - Readmission

KW - Reverse shoulder arthroplasty

KW - Total shoulder arthroplasty

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U2 - 10.1016/j.jor.2021.11.016

DO - 10.1016/j.jor.2021.11.016

M3 - Article

AN - SCOPUS:85120786863

SN - 0972-978X

VL - 28

SP - 126

EP - 133

JO - Journal of Orthopaedics

JF - Journal of Orthopaedics

ER -

Outpatient versus inpatient total shoulder arthroplasty: A cost and outcome comparison in a comorbidity matched analysis

Abstract

Keywords

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