Trends in Medicare Utilization and Reimbursement for Intertrochanteric Femur Fractures: A 21-Year Review.

IF 1.4 Q3 ORTHOPEDICS European Journal of Orthopaedic Surgery and Traumatology Pub Date : 2024-11-21 DOI:10.1007/s00590-024-04147-7

Evan H Richman, Joseph C Brinkman, Benjamin R Paul, Nicole Griffin, Nicholas Alfonso

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Abstract

Purpose: Sliding hip screw (SHS) and intramedullary (IMN) constructs are commonly utilized treatments for intertrochanteric (IT) femur fractures. The aim of this study was to assess the economic and utilization trends in the management of IT fractures among the Medicare population over the last 21 years.

Methods: A review of the publicly available Medicare Part B National Summary Data File for years 2000-2021 was performed. Collected data included true physician reimbursement and utilization numbers for all CPT codes pertaining to fixation of IT fractures with either SHS or IMN.

Results: A total of 1,361,112 IMN implants and 739,032 SHS implants were billed to Medicare for intertrochanteric femur fractures during the studied timeline. In this 21-year span, utilization of IMN increased 695% (9648-76,667), while utilization of SHS decreased by 96% (94,223-4224). After adjusting for inflation, the average physician reimbursement for SHS decreased by 34%, while IMN decreased by 41%. Absolute physician reimbursement was found to be $943.36 for SHS and $999.88 for IMN constructs.

Conclusion: Intramedullary implants are being increasingly utilized while sliding hip screw, and intramedullary construct reimbursement continues to decrease for intertrochanteric femur fracture fixation. These trends suggest that opting for a sliding hip screw may be more cost-effective when the fracture pattern allows for either construct.

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股骨转子间骨折的医疗保险使用和报销趋势：21 年回顾。

目的：滑动髋螺钉（SHS）和髓内（IMN）结构是治疗股骨转子间（IT）骨折的常用方法。本研究旨在评估过去 21 年来医疗保险人群中治疗股骨转子间骨折的经济和使用趋势：方法：对公开的 2000-2021 年医疗保险 B 部分国家汇总数据文件进行了审查。收集的数据包括与使用 SHS 或 IMN 固定 IT 骨折相关的所有 CPT 代码的真实医生报销和使用数量：结果：在所研究的时间段内，共有 1,361,112 例 IMN 植入物和 739,032 例 SHS 植入物因股骨转子间骨折而被医疗保险报销。在这 21 年间，IMN 的使用率增加了 695% (9648-76667)，而 SHS 的使用率减少了 96% (94223-4224)。扣除通货膨胀因素后，医生对 SHS 的平均报销额下降了 34%，而 IMN 则下降了 41%。髓内植入物的绝对医生报销额为 943.36 美元，髓内植入物的绝对医生报销额为 999.88 美元：结论：在使用滑动髋螺钉的同时，髓内植入物的使用率越来越高，而股骨转子间骨折固定的髓内结构报销额度持续下降。这些趋势表明，当骨折模式允许使用两种结构时，选择滑动髋螺钉可能更具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Orthopaedic Surgery and Traumatology 医学-整形外科

CiteScore

3.00

自引率

5.90%

发文量

265

审稿时长

3-8 weeks

期刊介绍： The European Journal of Orthopaedic Surgery and Traumatology (EJOST) aims to publish high quality Orthopedic scientific work. The objective of our journal is to disseminate meaningful, impactful, clinically relevant work from each and every region of the world, that has the potential to change and or inform clinical practice.