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Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?

BACKGROUND: Health disparities disproportionately affect minority groups across the United States with respect to care access, quality, and outcomes. The aim of this study is to examine existing disparities between white and African American (AA) patients regarding postoperative outcomes following t...

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Autores principales: Holbert, S. Elliott, Brennan, Jane C., Johnson, Andrea H., MacDonald, James H., Turcotte, Justin J., King, Paul J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772798/
https://www.ncbi.nlm.nih.gov/pubmed/36568850
http://dx.doi.org/10.1016/j.artd.2022.10.009
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author Holbert, S. Elliott
Brennan, Jane C.
Johnson, Andrea H.
MacDonald, James H.
Turcotte, Justin J.
King, Paul J.
author_facet Holbert, S. Elliott
Brennan, Jane C.
Johnson, Andrea H.
MacDonald, James H.
Turcotte, Justin J.
King, Paul J.
author_sort Holbert, S. Elliott
collection PubMed
description BACKGROUND: Health disparities disproportionately affect minority groups across the United States with respect to care access, quality, and outcomes. The aim of this study is to examine existing disparities between white and African American (AA) patients regarding postoperative outcomes following total joint arthroplasty and provide insight into disparity trends over a 9-year period. METHODS: A retrospective review of 16,779 total joint arthroplasty patients at a single institution between January 2013 and December 2021 was performed. Patients were grouped by race as AA or white. Outcomes of interest included length of stay (LOS), home discharge, 30-day emergency department return, and 30-day readmission. Univariate statistics and multivariate regressions were utilized to analyze results. RESULTS: Significant improvements in LOS and rates of home discharge occurred for both white and AA patients at our institution over a 9-year period, while rates of 30-day emergency department returns and readmissions demonstrated a downward but non–statistically significant trend. Despite these trends, AA patients continued to experience longer lengths of stay, less likelihood of 0- or 1-day LOS, and higher risk of nonhome discharge for most years examined. However, after controlling for demographic and comorbidity differences, the differences between groups narrowed over time resulting in no significant differences in the aforementioned 3 measures by 2021. CONCLUSIONS: Although racial disparities in outcomes are still apparent, over time, the differences in resource utilization between AA and white patients have narrowed. Initiatives aimed at creating healthier communities with increased access to care and the ultimate goal of equitable care must continue to be pursued.
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spelling pubmed-97727982022-12-23 Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress? Holbert, S. Elliott Brennan, Jane C. Johnson, Andrea H. MacDonald, James H. Turcotte, Justin J. King, Paul J. Arthroplast Today Original Research BACKGROUND: Health disparities disproportionately affect minority groups across the United States with respect to care access, quality, and outcomes. The aim of this study is to examine existing disparities between white and African American (AA) patients regarding postoperative outcomes following total joint arthroplasty and provide insight into disparity trends over a 9-year period. METHODS: A retrospective review of 16,779 total joint arthroplasty patients at a single institution between January 2013 and December 2021 was performed. Patients were grouped by race as AA or white. Outcomes of interest included length of stay (LOS), home discharge, 30-day emergency department return, and 30-day readmission. Univariate statistics and multivariate regressions were utilized to analyze results. RESULTS: Significant improvements in LOS and rates of home discharge occurred for both white and AA patients at our institution over a 9-year period, while rates of 30-day emergency department returns and readmissions demonstrated a downward but non–statistically significant trend. Despite these trends, AA patients continued to experience longer lengths of stay, less likelihood of 0- or 1-day LOS, and higher risk of nonhome discharge for most years examined. However, after controlling for demographic and comorbidity differences, the differences between groups narrowed over time resulting in no significant differences in the aforementioned 3 measures by 2021. CONCLUSIONS: Although racial disparities in outcomes are still apparent, over time, the differences in resource utilization between AA and white patients have narrowed. Initiatives aimed at creating healthier communities with increased access to care and the ultimate goal of equitable care must continue to be pursued. Elsevier 2022-12-14 /pmc/articles/PMC9772798/ /pubmed/36568850 http://dx.doi.org/10.1016/j.artd.2022.10.009 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Holbert, S. Elliott
Brennan, Jane C.
Johnson, Andrea H.
MacDonald, James H.
Turcotte, Justin J.
King, Paul J.
Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title_full Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title_fullStr Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title_full_unstemmed Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title_short Racial Disparities in Outcomes of Total Joint Arthroplasty at a Single Institution: Have We Made Progress?
title_sort racial disparities in outcomes of total joint arthroplasty at a single institution: have we made progress?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772798/
https://www.ncbi.nlm.nih.gov/pubmed/36568850
http://dx.doi.org/10.1016/j.artd.2022.10.009
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