AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium: Editorial Comment: A Call to Arms: Eliminating Musculoskeletal Healthcare Disparities

O’Connor, Mary I.; Lavernia, Carlos J.; Nelson, Charles L.

doi:10.1007/s11999-011-1884-0

Cited by 28 publications

(19 citation statements)

References 8 publications

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“…15,31-33 Legislative enactments including the Affordable Care Act and the expansion of Medicaid have also increased access to emergency care for many minority groups 14,34,35 while also possibly increasing quality of care for these patients through pay-for-performance and public quality reporting programs. 4 In parallel, orthopaedic-specific initiatives by the American Academy of Orthopaedic Surgeons 9 and others 8-10,13 have sought to eliminate disparities in orthopaedic care through research initiatives, such as the “Musculoskeletal Healthcare Disparities Symposium” and priority action plans aimed at raising awareness, while also attempting to increase diversity within the orthopaedics workforce. Although these efforts are commendable and improvements have been observed, the narrowing of these disparities has not necessarily resulted in their elimination, and several other disparities have continued to persist without notable improvement.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Hip Fracture Surgery Care in the United States From 2006 to 2015: A Nationwide Trends Study

Amen

Varady

Shannon

et al. 2021

J Am Acad Orthop Surg

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Background: Racial and ethnic disparities in the surgical treatment of hip fractures have been previously reported, demonstrating delayed time to surgery and worse perioperative outcomes for minority patients. However, data are lacking on how these disparities have trended over time and whether national efforts have succeeded in reducing them. The aim of this study was to investigate temporal trends in racial and ethnic disparities in perioperative metrics for patients undergoing hip fracture surgery in the United States from 2006 to 2015. Methods: The National Inpatient Sample was queried for White, Black, Hispanic, and Asian patients who underwent hip fracture surgery between 2006 and 2015. Perioperative metrics, including delayed time to surgery ($2 calendar days from admission to surgical intervention), length of stay (LOS), total inpatient complications, and mortality, were trended over time. Changes in racial and ethnic disparities were assessed using linear and logistic regression models.Results: During the study period, there were persistent disparities in delayed time to surgery for White versus Black, Hispanic, and Asian patients (eg, White versus Black: 30.1% versus 39.7% in 2006 and 22% versus 28.8% in 2015, P trend . 0.05 for all). Although disparities in total LOS remained consistent for White versus Black patients (P trend = 0.97), these disparities improved for White versus Hispanic and Asian patients (eg, White versus Hispanic: 4.8 days versus 5.3 in 2006 and 4.1 days versus 4.4 in 2015, P trend , 0.05 for both). Discussion: Racial and ethnic disparities were persistent in time to surgery and discharge disposition for hip fracture surgery between White and minority patients from 2006 to 2015 in the United States. These disparities particularly affected Black patients. Although there were encouraging signs of improving disparities in the LOS, these

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Hip Fracture Surgery Care in the United States From 2006 to 2015: A Nationwide Trends Study

Amen

Varady

Shannon

et al. 2021

J Am Acad Orthop Surg

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“…Some of this progress in reducing disparities in TJA care may be due to deliberate efforts on the part of policy makers and professional societies to increase awareness of the existing disparities. For example, the Musculoskeletal Healthcare Disparities Research Symposium organized by the American Academy of Orthopaedic Surgeons included a “call to arms” to reduce racial disparities with measures such as promoting research on health care disparities, diversifying the orthopedic physician workforce, and educating health care providers on disparities ( 49 ).…”

Section: Recent Advancesmentioning

confidence: 99%

Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis

Usiskin

Misra

2022

ACR Open Rheumatology

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Total joint arthroplasty (TJA) is an effective elective surgical procedure for knee and hip osteoarthritis (OA), yet racial disparities in the use of and outcomes from TJA have been recognized. Racial minority individuals are less willing to undergo TJA, demonstrate worse surgical and functional outcomes, and are more likely to undergo surgery at a low‐procedure‐volume center. In this systematic review, we summarize evidence to date on racial disparities in TJA and discuss potential factors that may underlie this gap in care for patients with OA.

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“…Several federal programs and scientific community initiatives have been launched to address racial disparities in health care during the past two decades 5 – 7 . In 2011, the Department of Health and Human Services announced a multidimensional plan to address the racial gap in healthcare: this plan included policy modifications, funding redistribution, and rewards for the care of socially disadvantaged populations, among others.…”

Section: Addressing Surgical Disparitiesmentioning

confidence: 99%

“…And it should be noted that these estimates were risk-adjusted for comorbidities, hospital characteristics, baseline patient status, and other factors, with the unadjusted discrepancies being even wider. The fact that Black patients receive a lower quality of care has been a known fact for over four decades 2 – 4 , but despite several efforts to address the problem 5 – 7 , the gap is far from closed 8 .…”

mentioning

confidence: 99%

Addressing racial disparities in surgical care with machine learning

2022

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There is ample evidence to demonstrate that discrimination against several population subgroups interferes with their ability to receive optimal surgical care. This bias can take many forms, including limited access to medical services, poor quality of care, and inadequate insurance coverage. While such inequalities will require numerous cultural, ethical, and sociological solutions, artificial intelligence-based algorithms may help address the problem by detecting bias in the data sets currently being used to make medical decisions. However, such AI-based solutions are only in early development. The purpose of this commentary is to serve as a call to action to encourage investigators and funding agencies to invest in the development of these digital tools.

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AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium: Editorial Comment: A Call to Arms: Eliminating Musculoskeletal Healthcare Disparities

Cited by 28 publications

References 8 publications

Racial and Ethnic Disparities in Hip Fracture Surgery Care in the United States From 2006 to 2015: A Nationwide Trends Study

Racial and Ethnic Disparities in Hip Fracture Surgery Care in the United States From 2006 to 2015: A Nationwide Trends Study

Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis

Addressing racial disparities in surgical care with machine learning

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