The purpose of this study was to evaluate the effect of common medical comorbidities on the reimbursements of different shoulder arthroplasty procedures We conducted a retrospective query of a private payer insurance claims database of prospectively collected data (PealDiver). Our search included the Current Procedural Terminology Codes (CPT) and International Classification of Disease (ICD) ninth edition codes for Total Shoulder Arthroplasty (TSA), Hemiarthroplasty (HA) and Reverse Shoulder Arthroplasty (RSA). Medical comorbidities were also searched for through ICD codes. The comorbidities selected for analysis were obesity, morbid obesity, hypertension, smoking, diabetes mellitus, hyperlipidemia, atrial fibrillation, chronic obstructive pulmonary disease (COPD), cirrhosis, depression and chronic kidney disease (CKD) (excluding end stage renal disease). The study period comprised claims from 2010 to 2014. The reimbursement charges of the day of surgery, 90-day global period and 90-day period excluding the initial surgical day of each comorbidity were analyzed and compared. Statistical analysis was conducted trough analysis of variance (ANOVA) when the data was normally distributed or through Kruskal-Wallis comparison when it was not. An alpha value of less than 0.05 was deemed as significant.Purpose
Methods
Operative treatment of complex proximal humerus fractures remains controversial. The transition to value-based health care demands a better understanding of the costs associated with surgery. The purpose of this study was to examine the 90-day costs of three common surgical treatments for proximal humerus fractures and non-operative treatment and compare the costs associated with the initial-day and subsequent 89-days of care. A query of the Humana insurance claims database was performed through the PearlDiver Supercomputer (Warsaw, IN) from 2010 to 2014 using the diagnosis codes for proximal humerus fractures together with current procedural terminology codes (CPT) for hemiarthroplasties (HA), open reduction internal fixation (ORIF), reverse shoulder arthroplasty (RSA) and nonoperative treatment (NO). Reimbursement from the insurance claims database was used as a marker for costs. The same day, subsequent 89-day, and ninety day costs were analyzed trough the use of descriptive and comparative statistical analysis.Background
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