Disparity in Total Joint Arthroplasty Patient Comorbidities, Demographics, and Postoperative Outcomes Based on Insurance Payer Type

Little is known about how patient characteristics differ between insurance types. We reviewed 293 consecutive primary total joint arthroplasty patients with 12-month follow-up and stratified them based on insurance type. As compared with patients with either Medicare or private insurance, Medicaid patients traveled an extra 160 to 170 miles for access to care, both Iowa Care and Medicaid were more than 3 times more likely to be current smokers, and both Iowa Care and Medicaid had lower preoperative and 12-month postoperative 36-Item Short Form Health Survey and WOMAC outcomes scores. Payer type was a significant predictor of 36-Item Short Form Health Survey physical function at final follow-up in a multivariate analysis. Significant disparities exist between patients with different insurance payer types in total joint arthroplasty, and further research into these differences is necessary.