Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States
Background:. As the incidence of shoulder arthroplasty rises at exponential rates, race is an important consideration, as racial disparities have been reported in lower-extremity arthroplasty in the United States. Our study sought to examine these disparities. Methods:. Using the National Inpatient...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-06-01
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| Series: | JBJS Open Access |
| Online Access: | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00144 |
| _version_ | 1818249584198025216 |
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| author | Kevin X. Farley, MD Alexander M. Dawes, BS Jacob M. Wilson, MD Roy J. Toston, BS John T. Hurt, BS Michael B. Gottschalk, MD Ronald A. Navarro, MD Eric R. Wagner, MD |
| author_facet | Kevin X. Farley, MD Alexander M. Dawes, BS Jacob M. Wilson, MD Roy J. Toston, BS John T. Hurt, BS Michael B. Gottschalk, MD Ronald A. Navarro, MD Eric R. Wagner, MD |
| author_sort | Kevin X. Farley, MD |
| collection | DOAJ |
| description | Background:. As the incidence of shoulder arthroplasty rises at exponential rates, race is an important consideration, as racial disparities have been reported in lower-extremity arthroplasty in the United States. Our study sought to examine these disparities.
Methods:. Using the National Inpatient Sample (NIS) database, all anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (RSA) procedures from 2011 to 2017 were analyzed. The patients were divided into the Black, Hispanic, and White groups.
Results:. Overall, 91.4% of the patients undergoing any shoulder arthroplasty procedure were White, 4.75% were Black, and 3.85% were Hispanic. Age and sex-standardized RSA utilization rates (per 100,000) in White patients increased by 139% from 6.94 in 2011 to 16.60 in 2017. The disparity for Black patients, compared with White patients, was 118% in 2011 and 124% in 2017; the disparity for Hispanic patients was 112% in 2011 and 103% in 2017. Similar disparities in aTSA utilization rates were seen; when compared with White patients, there was a 150% disparity in 2011 and a 197% disparity in 2017 for Black patients, and a 169% disparity in 2011 and a 262% disparity in 2017 for Hispanic patients. Finally, Blacks had a higher rate of non-home discharge, longer length of stay, and higher overall costs, while Hispanics had a longer length of stay and higher cost than Whites.
Conclusions:. Despite many efforts to reduce racial disparities in health-care utilization, the chasm in shoulder arthroplasty in the United States appears to be large and widening further. The exponential increase in utilization of shoulder arthroplasty has not been shared equally among races, and the disparities are larger than those reported in lower-extremity arthroplasty. |
| first_indexed | 2024-12-12T15:38:49Z |
| format | Article |
| id | doaj.art-568cbed9ce0c46ad83a1bb23531fa4bd |
| institution | Directory Open Access Journal |
| issn | 2472-7245 |
| language | English |
| last_indexed | 2024-12-12T15:38:49Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | JBJS Open Access |
| spelling | doaj.art-568cbed9ce0c46ad83a1bb23531fa4bd2022-12-22T00:19:57ZengWolters KluwerJBJS Open Access2472-72452022-06-017210.2106/JBJS.OA.21.00144JBJSOA2100144Racial Disparities in the Utilization of Shoulder Arthroplasty in the United StatesKevin X. Farley, MD0Alexander M. Dawes, BS1Jacob M. Wilson, MD2Roy J. Toston, BS3John T. Hurt, BS4Michael B. Gottschalk, MD5Ronald A. Navarro, MD6Eric R. Wagner, MD71 Department of Orthopaedic Surgery, Oakland University William Beaumont Orthopaedics, Royal Oaks, Michigan2 Division of Upper Extremity, Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia3 Division of Adult Reconstruction, Department of Orthopedic Surgery, Mayo Clinic Rochester, Rochester, Minnesota2 Division of Upper Extremity, Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia2 Division of Upper Extremity, Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia2 Division of Upper Extremity, Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia4 Department of Orthopaedic Surgery, Kaiser Permanente, Pasadena, California2 Division of Upper Extremity, Department of Orthopaedic Surgery, Emory University, Atlanta, GeorgiaBackground:. As the incidence of shoulder arthroplasty rises at exponential rates, race is an important consideration, as racial disparities have been reported in lower-extremity arthroplasty in the United States. Our study sought to examine these disparities. Methods:. Using the National Inpatient Sample (NIS) database, all anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (RSA) procedures from 2011 to 2017 were analyzed. The patients were divided into the Black, Hispanic, and White groups. Results:. Overall, 91.4% of the patients undergoing any shoulder arthroplasty procedure were White, 4.75% were Black, and 3.85% were Hispanic. Age and sex-standardized RSA utilization rates (per 100,000) in White patients increased by 139% from 6.94 in 2011 to 16.60 in 2017. The disparity for Black patients, compared with White patients, was 118% in 2011 and 124% in 2017; the disparity for Hispanic patients was 112% in 2011 and 103% in 2017. Similar disparities in aTSA utilization rates were seen; when compared with White patients, there was a 150% disparity in 2011 and a 197% disparity in 2017 for Black patients, and a 169% disparity in 2011 and a 262% disparity in 2017 for Hispanic patients. Finally, Blacks had a higher rate of non-home discharge, longer length of stay, and higher overall costs, while Hispanics had a longer length of stay and higher cost than Whites. Conclusions:. Despite many efforts to reduce racial disparities in health-care utilization, the chasm in shoulder arthroplasty in the United States appears to be large and widening further. The exponential increase in utilization of shoulder arthroplasty has not been shared equally among races, and the disparities are larger than those reported in lower-extremity arthroplasty.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00144 |
| spellingShingle | Kevin X. Farley, MD Alexander M. Dawes, BS Jacob M. Wilson, MD Roy J. Toston, BS John T. Hurt, BS Michael B. Gottschalk, MD Ronald A. Navarro, MD Eric R. Wagner, MD Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States JBJS Open Access |
| title | Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States |
| title_full | Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States |
| title_fullStr | Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States |
| title_full_unstemmed | Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States |
| title_short | Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States |
| title_sort | racial disparities in the utilization of shoulder arthroplasty in the united states |
| url | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00144 |
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