Frequency and Complications of Major Orthopedic Procedures in Medicare Beneficiaries
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Arthritis, Arthritis, Rheumatoid Arthritis, Neurology, Neurology |
| Therapuetic Areas: | Neurology, Rheumatology |
| Healthy: | No |
| Age Range: | 20 - 100 |
| Updated: | 2/10/2019 |
| Start Date: | October 31, 2014 |
| End Date: | May 30, 2020 |
Background:
- Orthopedic procedures are common in the United States. These include joint replacement and
spine surgeries. Researchers want to study data about these procedures over time. They want
to see if treatment has gotten better. They also want to find ways to change the care that
people get before and after they have these procedures. These changes may lower the risk of
problems people can have during and after treatment. They may also improve people s results.
Objectives:
- To study a series of questions about surgery, medicine, treatments, and outcomes for
orthopedic procedures.
Eligibility:
- Data from the U.S. Centers for Medicare and Medicaid Services from 1999 to 2015.
Design:
- Researchers will look at data for people ages 20-100.
- No new participants will be used in this study.
- The study will last 6 years.
- Orthopedic procedures are common in the United States. These include joint replacement and
spine surgeries. Researchers want to study data about these procedures over time. They want
to see if treatment has gotten better. They also want to find ways to change the care that
people get before and after they have these procedures. These changes may lower the risk of
problems people can have during and after treatment. They may also improve people s results.
Objectives:
- To study a series of questions about surgery, medicine, treatments, and outcomes for
orthopedic procedures.
Eligibility:
- Data from the U.S. Centers for Medicare and Medicaid Services from 1999 to 2015.
Design:
- Researchers will look at data for people ages 20-100.
- No new participants will be used in this study.
- The study will last 6 years.
Major orthopedic procedures, including total joint replacement and spine surgeries, are among
the most common procedures in the population. Learning about how often these surgeries are
performed can give indications of whether the treatment of arthritis and other
musculoskeletal conditions has been improving over time. Learning about the complications
associated with these surgeries can give indications about ways to alter the care of patients
before and after surgeries that may decrease the risk of complications and improve patient
outcomes. We will analyze Medicare and Medicaid data from 1999 to 2015 to examine a series of
questions, including whether the use of joint replacement surgery has changed over time among
patients with rheumatoid arthritis and ankylosing spondylitis, to see if rheumatoid arthritis
medications are associated with some types of surgical complications, to see if
anticoagulation medication after joint replacement is associated with the risk of
complications, to see if regional differences in surgery rates can be explained by
differences in patient characteristics, and to determine the surgical treatment for hip
fractures that is associated with the fewest long-term complications. From the Framingham
Heart Study Cohort, we will study the changes in the incidence of hip fractures and the risk
factors for osteoporosis over time.
the most common procedures in the population. Learning about how often these surgeries are
performed can give indications of whether the treatment of arthritis and other
musculoskeletal conditions has been improving over time. Learning about the complications
associated with these surgeries can give indications about ways to alter the care of patients
before and after surgeries that may decrease the risk of complications and improve patient
outcomes. We will analyze Medicare and Medicaid data from 1999 to 2015 to examine a series of
questions, including whether the use of joint replacement surgery has changed over time among
patients with rheumatoid arthritis and ankylosing spondylitis, to see if rheumatoid arthritis
medications are associated with some types of surgical complications, to see if
anticoagulation medication after joint replacement is associated with the risk of
complications, to see if regional differences in surgery rates can be explained by
differences in patient characteristics, and to determine the surgical treatment for hip
fractures that is associated with the fewest long-term complications. From the Framingham
Heart Study Cohort, we will study the changes in the incidence of hip fractures and the risk
factors for osteoporosis over time.
- Subjects will be either Medicare or Medicaid beneficiaries with available claims from
1999 to 2014. For projects requiring detailed medication information, inclusion will
be limited to those with Part D claims from 2006 to 2014. Eligibility for each project
will be based on claims for the appropriate disease (e.g. RA) or procedure (e.g. hip
arthroplasty).
Medicare beneficiaries will be excluded (or censored) if they do not have both Part A and
Part B coverage, or enrolled in Medicare Advantage plans (Part C), as detailed claims for
these beneficiaries are not available. We will also exclude dual-eligible (Medicare and
Medicaid recipients) as these subjects have distinct clinical conditions (e.g. blindness)
that distinguishes them from most Medicare beneficiaries. There will be no exclusions based
on gender, race, ethnicity, or cognitive impairment.
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Bethesda, Maryland 20892
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