Elective surgery elicits a systemic immune response and may result in immunosuppression in certain patients. It is currently unknown whether patients are at an increased risk for viral infection and associated illness in the immediate postoperative period following total joint arthroplasty. This question has become more important given the ongoing coronavirus disease 2019 (COVID-19) pandemic. We analyzed 3 large administrative datasets (Medicare 5% and 100% standard analytic files, Humana claims database) to identify patients who underwent total knee arthroplasty (TKA) and total hip arthroplasty (THA) from 2005 to 2013. The influenza vaccination status of each patient was defined using the presence or absence of a code for vaccination. The incidence of a flu diagnosis was recorded in both vaccinated and unvaccinated patients at 1 month, 3 months, and 6 months following the date of surgery and was compared to a cohort of vaccinated patients who did not undergo surgery.Introduction
Methods
As total knee arthroplasty incidence in the United States continues to increase, health care entities are looking to reform policy to decrease costs while improving efficiency and quality of care. The allocation of hospital and surgeon charges and payments is an important aspect of health care economics, but the trends and relationship between surgeon and hospital charges and payments for knee arthroplasty have not been well examined. The goal of this study is to report trends and variation in hospital charges and payments compared to surgeon charges and payments for total knee arthroplasty in a Medicare population. The 5% Medicare sample was used to capture hospital and surgeon charges and payments for total knee arthroplasty from 2005–2014. Two important values were calculated: (1) the charge multiplier (CM) which is the ratio of hospital to surgeon charges, and (2) the payment multiplier (PM), which is the ratio of hospital to surgeon payments. The year to year variation and regional trends in patient demographics, Charlson Comorbidity Index (CCI), length of stay (LOS), CM and PM were evaluated for all patients. Statistical significance of trends was evaluated using student's t-tests. Correlations between the financial multipliers and LOS were evaluated using a Pearson correlation coefficient (r).Introduction
Methods
Dialysis has been associated with increased complication rates following total knee arthroplasty (TKA). However, the current literature on this topic is limited and does not distinguish between hemodialysis (HD) and peritoneal dialysis (PD). It is unknown if the type of dialysis influences the risks of adverse outcome. The purpose of this study was to determine if infection and complication rates after TKA differ based on the mode of dialysis. Patients undergoing primary TKA from 2005 to 2014 were identified in the Medicare database. Patients with PD were matched 1:1 to patients with HD and 1:3 with patients who were not receiving either form of dialysis. Multivariate regression analysis was performed to examine several adverse events including the incidence of infection at 1 year and readmission to the hospital at 30 days.Introduction
Methods
