Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 3:17585732251362298.
doi: 10.1177/17585732251362298. Online ahead of print.

Social determinants of health predict increased length of stay but not complications following primary total shoulder arthroplasty in Medicaid patients

Anthony J Minerva  1 , John W Moore  1 , Alexander S Guareschi  2 , Cody Ashy  1 , Brandon L Rogalski  1 , Richard J Friedman  1
Affiliations

Social determinants of health predict increased length of stay but not complications following primary total shoulder arthroplasty in Medicaid patients

Anthony J Minerva et al. Shoulder Elbow. .

Abstract

Introduction: Social determinants of health (SDOHs) are nonmedical influences on healthcare, including sociocultural and economic factors. The purpose of this study was to determine if preoperative International Classification of Disease, tenth revision (ICD-10) code diagnoses of SDOH were predictive of increased complication following primary total shoulder arthroplasty (TSA) in Medicaid patients.

Methods: The National Readmissions Database was queried from 2016 to 2020 to identify Medicaid patients with preoperative diagnoses of SDOH (n = 275) and Medicaid patients without preoperative diagnoses of SDOH (n = 5297) undergoing elective primary TSA. Regression analysis was used to identify independent predictors of complications, increased cost, and increased hospital length of stay (LOS).

Results: Diagnoses of SDOH were correlated with increased odds of 180-day readmission and mortality, increased surgical site infection, and increased cost and LOS. Following regression analysis, diagnoses of SDOH were not independently predictive of any complication, readmission, or mortality, but were predictive of increased LOS.

Conclusion: ICD-10 code diagnoses of SDOH were independently predictive of increased LOS in Medicaid patients undergoing primary TSA, but were not independently predictive of complications, readmission, mortality, or increased cost. This study focused on a population with less economic variance than previous studies. In a population economically disadvantaged, these findings provide insightful considerations for physicians and patients given the increased resource utilization associated.Level of evidence: Level III - Retrospective cohort study.

Keywords: Medicaid; Social determinants of health; arthroplasty; complications; shoulder.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

References

    1. Goetti P, Denard PJ, Collin P, et al. Biomechanics of anatomic and reverse shoulder arthroplasty. EFORT Open Rev 2021; 6: 918–931. - PMC - PubMed
    1. Best MJ, Aziz KT, Wilckens JH, et al. Increasing incidence of primary reverse and anatomic total shoulder arthroplasty in the United States. J Shoulder Elbow Surg 2021; 30: 1159–1166. - PubMed
    1. Anakwenze OA, O'Donnell EA, Jobin CM, et al. Medical complications and outcomes after total shoulder arthroplasty: a nationwide analysis. Am J Orthop (Belle Mead NJ) 2018; 47. DOI: 10.12788/ajo.2018.0086 - DOI - PubMed
    1. Dawes AM, Farley KX, Godfrey WS, et al. Medicaid payer status is associated with increased 90-day morbidity and resource utilization following primary shoulder arthroplasty: a propensity score-matched analysis. J Shoulder Elbow Surg 2023; 32: 104–110. - PubMed
    1. Medicaid and Chip Enrollment Trend Snapshot, https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enro... (2024, accessed September 7 2024).

LinkOut - more resources