Purpose
To evaluate the prevalence of preoperatively diagnosed psychiatric comorbidities and
the impact of these comorbidities on the healthcare costs of ten common orthopaedic
sports medicine procedures.
Methods
Patients undergoing 10 common sports medicine procedures from 2007 to 2017q1 were
identified using the Humana claims database. These procedures included anterior cruciate
ligament reconstruction; posterior cruciate ligament reconstruction; medial collateral
ligament repair/reconstruction; Achilles repair/reconstruction; Rotator cuff repair;
meniscectomy/meniscus repair; hip arthroscopy; arthroscopic shoulder labral repair;
patellofemoral instability procedures; and shoulder instability repair. Patients were
stratified by preoperative diagnoses of depression, anxiety, bipolar disorder, or
schizophrenia. Cohorts included patients with ≥1 psychiatric comorbidity (psychiatric)
versus those without psychiatric comorbidities (no psychiatric). Differences in costs
across groups were compared using Mann–Whitney U tests, with significance defined as P < .05. Linear regression analysis was used to assess rates of procedures per year
from 2006 to 2016.
Results
In total, 226,402 patients (57.7% male) from 2007 to 2017q1 were assessed. The prevalence
of ≥1 psychiatric comorbidity within the entire database was 10.31% (reference) versus
21.21% in those patients undergoing the 10 investigated procedures. Patients with
psychiatric comorbidity most frequently underwent rotator cuff repair (28%), hip labral
repair (26.3%) and meniscectomy/meniscus repair (25.0%%) had ≥1 psychiatric comorbidity.
Compared with the no psychiatric cohort, diagnosis of ≥1 psychiatric comorbidity was
associated with increased health care costs for all 10 sports medicine procedures
($9678.81 vs $6436.20, P < .0001).
Conclusions
The prevalence of preoperatively diagnosed psychiatric comorbidities among patients
undergoing orthopaedic sports medicine procedures is high. The presence of psychiatric
comorbidities preoperatively was associated with increased postoperative costs following
all investigated orthopaedic sports medicine procedures.
Level of Evidence
Level III; retrospective comparative study.
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Article info
Publication history
Published online: October 24, 2020
Accepted:
October 16,
2020
Received:
May 12,
2020
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.R.W. reports other from American Journal of Sports Medicine, other from American Orthopaedic Society for Sports Medicine, other from Arthroscopy, other from Arthrex, personal fees from CONMED Linvatec, other from Mid-America Orthopaedic Association, other from Smith & Nephew, and other from SportsMed Innovate, outside the submitted work. K.R.D. reports other from Arthrex and Zimmer, outside the submitted work. R.W.W. reports other from American Journal of Sports Medicine, other from American Orthopaedic Society for Sports Medicine, other from Arthroscopy, personal fees from CONMED Linvatec, and non-financial support from Smith & Nephew, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2020 by the Arthroscopy Association of North America
