Sex and Race Characteristics in Patients Undergoing Hip and Knee Arthroplasty in an Urban Setting
Section snippets
Methods
An observational study was conducted on 3542 consecutive primary unilateral total hip (n = 1596) and knee (n = 1946) arthroplasties performed at the NYU Hospital for Joint Diseases, New York, New York, between January 1997 and July 2006. Physical examinations and standardized questionnaires were administered to patients before their surgery. The data from these comprised the functional components of the Harris Hip Score and the Knee Society Score, which were used to quantify functional ability
Results
Harris Hip Scores were 4.9 (P < .0001) and 8.77 (P < .001) points lower in African American and Hispanic patients than white patients for the population, respectively. Similar findings were found in preoperative total knee arthroplasty patients with 6.03 (P < .06) and 12.8 (P < .001) lower average Knee Society Scores in African American and Hispanic patients than white patients for the population, respectively. For men, hip and knee scores were worse for Hispanics and African Americans relative
Discussion
Although, several studies have demonstrated worse function for women before joint arthroplasty 5, 6, this is the first to examine large groups of men and women in different racial groups. This study demonstrated several key findings in the urban population. First, African American and Hispanic patients presented with lower function scores than whites before hip and knee arthroplasty surgery, with Hispanics having the lowest scores of the 3 groups. Second, women demonstrated lower preoperative
Conclusion
This study demonstrates that Hispanic and African American patients have worse preoperative hip and knee function before arthroplasty than white patients. In particular, Hispanic men had worse function before hip and knee arthroplasty than both African American and white men, and Hispanic and African American women had significantly worse function before hip arthroplasty than white women. This is important because studies have demonstrated that lower preoperative function results in lower
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Socioeconomic Risk Adjustment Models for Reimbursement Are Necessary in Primary Total Joint Arthroplasty
2017, Journal of ArthroplastyCitation Excerpt :Detailed results from multivariate logistic regression analysis are shown in Tables 4-6. While other studies have examined disparities in care among patients from disadvantaged backgrounds undergoing primary TKA and THA [9,10,15,16], we present a consecutive series of 4168 patients identifying lowest SES (using ZIP code as a proxy for SES) as an independent risk factor for extended hospital LOS, readmission rate, and discharge disposition to a higher level of care. With the increasing incidence of bundled payment programs without risk adjustment reimbursement models, health care stakeholders have a financial incentive to provide care to patients at the lowest cost.
Disparities in Discharge Destination After Lower Extremity Joint Arthroplasty: Analysis of 7924 Patients in an Urban Setting
2016, Journal of ArthroplastyCitation Excerpt :We found female gender, TKA, lower-to-middle SES, black race/ethnicity, and advanced age to be associated with higher likelihood of discharge to an institution. Although several studies [6,7,23-25] have shown disproportionate incidence and higher rates of suboptimal outcomes by lower SES in joint arthroplasty patients, studies in the joint arthroplasty literature have been sparse on this topic of disparities in discharge destination. The reasons for the impact of SES are unclear but may relate to support and resources available to patients that would allow home discharge.
Gender and outcomes in total joint arthroplasty: a systematic review on healthcare disparities in the United States
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Our registry has been supported by educational grants from Smith and Nephew in the past.