Outpatient versus inpatient total shoulder arthroplasty: A cost and outcome comparison in a comorbidity matched analysis

Abstract

BackgroundPrevious studies comparing total and reverse shoulder arthroplasty (TSA/RSA) are subject to surgeon selection bias. This study objective is to compare the outcomes and cost of outpatient TSA/RSA to inpatient TSA/RSA. Methods108,889 elective inpatient and outpatient TSA/RSA from Medicare claims data (2016–2018). 90-day readmission and total 90-day costs were compared following propensity score matching. ResultsYounger and healthier patients are receiving outpatient TSA/RSA. Outpatient TSA/RSA was associated with fewer 90-day readmissions (OR 0.48 CI 0.38–0.59, p < 0.001) and lower 90-day costs (−20.1% CI -19.1%; −21.1%, p < 0.001). ConclusionsOutpatient TSA/RSA surgery offers lower complication rates and total costs. Level of evidenceIII.