Administrative Databases Used for Sports Medicine Research Demonstrate Significant Differences in Underlying Patient Demographics and Resulting Surgical Trends
Michelle Xiao, Joseph Donahue, Marc R. Safran, Seth L. Sherman, Geoffrey D. Abrams
Abstract
Purpose To discern differences between the PearlDiver and MarketScan databases with regards to patient demographics, costs, reoperations, and complication rates for isolated meniscectomy. Methods We queried the PearlDiver Humana Patient Records Database and the IBM MarketScan Commercial Claims and Encounters database for all patients who had record of meniscectomy denoted by Current Procedure Terminology 29880 or 29881 between January 1, 2007, and December 31, 2016. Those that had any other knee procedure at the same time as the meniscectomy were excluded, and the first instance of isolated meniscectomy was recorded. Patient demographics, Charlson Comorbidity Index, reoperations, 30‐ and 90‐day complication rates, and costs were collected from both databases. Pearson’s χ 2 test with Yate’s continuity correction and the Student t test were used to compare the 2 databases, and an alpha value of 0.05 was set as significant. Results We identified 441,147 patients with isolated meniscectomy from the MarketScan database (0.36% of total database), approximately 10 times the number of patients (n = 49,924; 0.20% of total database) identified from PearlDiver. The PearlDiver population was significantly older (median age: 65‐69) than the MarketScan cohort, where all patients were younger than 65 (median age: 52; P < .001). Average Charlson Comorbidity Index was significantly lower for MarketScan (0.172, standard deviation [SD]: 0.546) compared with PearlDiver (1.43, SD: 2.05; P < .001), even when we restricted the PearlDiver cohort to patients younger than 65 years (1.02, SD: 1.74; P < .001). The PearlDiver <65 years subcohort also had increased 30‐ (relative risk 1.53 [1.40‐1.67]) and 90‐day (relative risk 1.56 [1.47‐1.66]) postoperative complications compared with MarketScan. Overall, laterality coding was more prevalent in the PearlDiver database. Conclusions For those undergoing isolated meniscectomy, the MarketScan database comprised an overall larger and younger cohort of patients with fewer comorbidities, even when examining only subjects younger than 65 years of age. Level of Evidence Level III, retrospective comparative study.