PMID- 37463114 OWN - NLM STAT- MEDLINE DCOM- 20231017 LR - 20231017 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 51 IP - 10 DP - 2023 Aug TI - Effect of Insurance Reimbursement Status on Pre- and Postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Scores After Arthroscopic Rotator Cuff Repair. PG - 2659-2670 LID - 10.1177/03635465231185135 [doi] AB - BACKGROUND: Previous studies reported inferior patient-reported outcomes (PROs) after arthroscopic rotator cuff repair for patients receiving workers' compensation (WC) relative to patients with commercial insurance. The extent to which alternative insurance reimbursement, including Medicaid and Medicare, influences outcomes after arthroscopic rotator cuff repair remains understudied. HYPOTHESIS: Compared with patients with commercial insurance reimbursement, patients with WC or government-issued reimbursement would report lower pre- and postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) scores, report higher pre- and postoperative PROMIS Depression (D) and Pain Interference (PI) scores, and experience smaller levels of improvement in all PROMIS domains with surgical intervention. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Demographic and surgical data were extracted from the medical record, and PROMIS domains were prospectively collected. Patients were divided into cohorts based on insurance reimbursement status. Differences between insurance-based cohorts for baseline variables, pre- and postoperative PROMIS scores, and change from baseline to final follow-up (delta) for PROMIS scores were evaluated using Kruskal-Wallis or chi-square tests. Mixed-effects linear regression models were performed to assess the influence of insurance while controlling for other variables. Survival analysis was performed to determine time to achieve minimal clinically important difference (MCID) for each PROMIS domain per cohort. RESULTS: 1252 patients underwent arthroscopic rotator cuff repair, met inclusion criteria, and completed PROMIS questionnaires. Statistically significant differences were noted in demographic variables including age (P < .001), sex (P < .001), ethnicity (P < .001), and body mass index (P < .001) between insurance-based cohorts. Unadjusted analysis revealed significantly higher PF scores and lower PI and D scores for the group with commercial insurance relative to those with Medicare, Medicaid, and WC at 6- and 12-month follow-up (P < .01 all comparisons), except for the Medicare versus commercial subcohort analysis for PI at 6 months (P = .28). These differences persisted for the Medicare, Medicaid, and WC groups (P < .03 all comparisons) after adjustment for confounding variables in linear regression. CONCLUSIONS: The baseline characteristics of patients undergoing arthroscopic rotator cuff repair differed based on insurance reimbursement. Patients with commercial insurance reported improved physical function, decreased pain interference, and improved mood (less depression) relative to patients with government-issued and WC insurance, with maximum improvement 6 to 12 months postoperatively. There were few significant differences between insurance groups in change of PROMIS scores from preoperative to postoperative intervals, indicating that differences in the baseline demographic and surgical characteristics of these groups accounted for differences in response to surgery. FAU - Anderson, Devon E AU - Anderson DE AUID- ORCID: 0000-0002-4592-9265 AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Shaikh, Hashim J F AU - Shaikh HJF AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Chait, Alexander R AU - Chait AR AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Ramirez, Gabriel AU - Ramirez G AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Bronstein, Robert D AU - Bronstein RD AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Goldblatt, John P AU - Goldblatt JP AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Giordano, Brian D AU - Giordano BD AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Maloney, Michael D AU - Maloney MD AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Nicandri, Gregg T AU - Nicandri GT AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Voloshin, Ilya AU - Voloshin I AUID- ORCID: 0000-0003-0161-4314 AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Mannava, Sandeep AU - Mannava S AD - Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. LA - eng PT - Journal Article DEP - 20230718 PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Treatment Outcome MH - Information Systems MH - Patient Reported Outcome Measures MH - Arthroscopy MH - *Rotator Cuff Injuries/surgery MH - Humans MH - Male MH - Female MH - Adult MH - Middle Aged MH - Aged MH - Postoperative Complications OTO - NOTNLM OT - PROMIS OT - arthroscopy OT - insurance OT - rotator cuff repair EDAT- 2023/07/18 18:42 MHDA- 2023/08/10 06:43 CRDT- 2023/07/18 12:53 PHST- 2023/08/10 06:43 [medline] PHST- 2023/07/18 18:42 [pubmed] PHST- 2023/07/18 12:53 [entrez] AID - 10.1177/03635465231185135 [doi] PST - ppublish SO - Am J Sports Med. 2023 Aug;51(10):2659-2670. doi: 10.1177/03635465231185135. Epub 2023 Jul 18.