Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis
Background:. Advanced posttraumatic osteoarthritis (PTOA) of the knee is a cause of substantial disability, particularly in younger individuals, and the treatment of choice is total knee arthroplasty (TKA). Racial and socioeconomic disparities exist in the use of TKA, but, to our knowledge, there ha...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-09-01
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| Series: | JBJS Open Access |
| Online Access: | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.22.00017 |
| _version_ | 1828374069579350016 |
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| author | Joseph Atarere, MD, MPH Emeka Agudile, MD, MPH, ScD Vwaire Orhurhu, MD, MPH Ukamaka M. Agudile, MD George Sorescu, MD Zakari Aliyu Suleiman, MD Michael J. Weaver, MD Arvind Von Keudell, MD, MPH |
| author_facet | Joseph Atarere, MD, MPH Emeka Agudile, MD, MPH, ScD Vwaire Orhurhu, MD, MPH Ukamaka M. Agudile, MD George Sorescu, MD Zakari Aliyu Suleiman, MD Michael J. Weaver, MD Arvind Von Keudell, MD, MPH |
| author_sort | Joseph Atarere, MD, MPH |
| collection | DOAJ |
| description | Background:. Advanced posttraumatic osteoarthritis (PTOA) of the knee is a cause of substantial disability, particularly in younger individuals, and the treatment of choice is total knee arthroplasty (TKA). Racial and socioeconomic disparities exist in the use of TKA, but, to our knowledge, there have been no studies examining these disparities among patients with PTOA.
Methods:. We performed chi-square and logistic regression analyses on data from the Nationwide Inpatient Sample (NIS). The outcome of interest was the rate of TKA utilization, and the primary predictors were racial/ethnic group and insurance status. The regression models were adjusted for age, sex, household income, and Charlson Comorbidity Index (CCI).
Results:. The odds of receiving TKA for Black patients (odds ratio [OR] = 0.55; 95% confidence interval [CI], 0.48 to 0.62) and Hispanic patients (OR = 0.53; 95% CI, 0.46 to 0.62) were lower compared with White patients. Patients with Medicare (OR = 0.51; 95% CI, 0.46 to 0.57), those with Medicaid (OR = 0.48; 95% CI, 0.42 to 0.55), and those who self-paid (OR = 0.91, 95% CI: 0.14 to 0.25) had significantly lower odds of TKA compared with those with private insurance.
Conclusions:. Black and Hispanic patients are less likely than White patients to utilize TKA, and patients with private insurance are more likely to utilize TKA.
Level of Evidence:. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| first_indexed | 2024-04-14T07:27:56Z |
| format | Article |
| id | doaj.art-0eb5c439d34640c597f2a01f04bad1ea |
| institution | Directory Open Access Journal |
| issn | 2472-7245 |
| language | English |
| last_indexed | 2024-04-14T07:27:56Z |
| publishDate | 2022-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | JBJS Open Access |
| spelling | doaj.art-0eb5c439d34640c597f2a01f04bad1ea2022-12-22T02:05:57ZengWolters KluwerJBJS Open Access2472-72452022-09-017310.2106/JBJS.OA.22.00017JBJSOA2200017Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee OsteoarthritisJoseph Atarere, MD, MPH0Emeka Agudile, MD, MPH, ScD1Vwaire Orhurhu, MD, MPH2Ukamaka M. Agudile, MD3George Sorescu, MD4Zakari Aliyu Suleiman, MD5Michael J. Weaver, MD6Arvind Von Keudell, MD, MPH71 Department of Biostatistics and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts3 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts5 Department of Anesthesia, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania6 Department of Family Medicine, Federal Medical Center, Gusau, Zamfara, Nigeria7 Department of Internal Medicine, Lemuel Shattuck Hospital, Boston, Massachusetts8 Department of Anesthesia, University of Ilorin Teaching Hospital, Ilorin, Ondo, Nigeria9 Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts9 Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MassachusettsBackground:. Advanced posttraumatic osteoarthritis (PTOA) of the knee is a cause of substantial disability, particularly in younger individuals, and the treatment of choice is total knee arthroplasty (TKA). Racial and socioeconomic disparities exist in the use of TKA, but, to our knowledge, there have been no studies examining these disparities among patients with PTOA. Methods:. We performed chi-square and logistic regression analyses on data from the Nationwide Inpatient Sample (NIS). The outcome of interest was the rate of TKA utilization, and the primary predictors were racial/ethnic group and insurance status. The regression models were adjusted for age, sex, household income, and Charlson Comorbidity Index (CCI). Results:. The odds of receiving TKA for Black patients (odds ratio [OR] = 0.55; 95% confidence interval [CI], 0.48 to 0.62) and Hispanic patients (OR = 0.53; 95% CI, 0.46 to 0.62) were lower compared with White patients. Patients with Medicare (OR = 0.51; 95% CI, 0.46 to 0.57), those with Medicaid (OR = 0.48; 95% CI, 0.42 to 0.55), and those who self-paid (OR = 0.91, 95% CI: 0.14 to 0.25) had significantly lower odds of TKA compared with those with private insurance. Conclusions:. Black and Hispanic patients are less likely than White patients to utilize TKA, and patients with private insurance are more likely to utilize TKA. Level of Evidence:. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.22.00017 |
| spellingShingle | Joseph Atarere, MD, MPH Emeka Agudile, MD, MPH, ScD Vwaire Orhurhu, MD, MPH Ukamaka M. Agudile, MD George Sorescu, MD Zakari Aliyu Suleiman, MD Michael J. Weaver, MD Arvind Von Keudell, MD, MPH Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis JBJS Open Access |
| title | Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis |
| title_full | Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis |
| title_fullStr | Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis |
| title_full_unstemmed | Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis |
| title_short | Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis |
| title_sort | racial and socioeconomic disparities in the utilization of tka among patients with posttraumatic knee osteoarthritis |
| url | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.22.00017 |
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