Persisting Racial Disparities in Total Shoulder Arthroplasty Utilization and Outcomes

Singh, Jasvinder A.; Ramachandran, Rekha

doi:10.1007/s40615-015-0138-3

Cited by 38 publications

(45 citation statements)

References 43 publications

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“…The authors also found higher risks of AKA following knee arthroplasty for patients who were younger than 50 and older than 80 years of age. The current findings regarding disparities in AKA usage are consistent with other orthopaedic procedures shown to be associated with racial or gender disparities [11], including lower extremity arthroplasty [2,12], total shoulder arthroplasty [13], cervical spine surgery [14], lumbar stenosis [8], and hip fractures [3].…”

supporting

confidence: 77%

CORR Insights®: Racial Disparities in Above-knee Amputations after TKA: A National Database Study

Dougherty

2017

Clinical Orthopaedics &Amp; Related Research

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The author certifies that he nor any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR 1 or The Association of Bone and Joint Surgeons 1. This CORR Insights 1 comment refers to the article available at

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supporting

confidence: 77%

CORR Insights®: Racial Disparities in Above-knee Amputations after TKA: A National Database Study

Dougherty

2017

Clinical Orthopaedics &Amp; Related Research

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“…While healthcare utilization disparities have been shown in several areas of orthopedics, such as arthroplasty, upper extremity, and spinal surgeries, the literature has been limited within the field of orthopedic trauma [6, 8, 16]. Our study showed that several factors influence the treatment of closed calcaneus fractures in the US patient population.…”

Section: Discussionmentioning

confidence: 68%

“…Racial and social healthcare disparities have been identified within different elective areas of orthopedic surgery, such as hip and knee arthroplasty, shoulder arthroplasty, ankle arthroplasty, spinal fusion, cubital and carpal tunnel surgery, elective hardware removal following pediatric femoral shaft fractures, and treatment of meniscal tears [6–9, 13, 16–22]. In particular, minorities were significantly less likely to undergo these elective orthopedic procedures.…”

Section: Discussionmentioning

confidence: 99%

Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures

Zelle¹,

Morton-Gonzaba²,

Adcock³

et al. 2019

J Orthop Surg Res

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BackgroundSocio-demographic factors have been suggested to contribute to differences in healthcare utilization for several elective orthopedic procedures. Reports on disparities in utilization of orthopedic trauma procedures remain limited. The purpose of our study is to assess the roles of clinical and socio-demographic variables in utilization of operative fixation of calcaneus fractures in the USA.MethodsThe National Inpatient Sample (NIS) dataset was used to analyze all patients from 2005 to 2014 with closed calcaneal fractures. Multivariate logistic regression analyses were performed to evaluate the impact of clinical and socio-demographic variables on the utilization of surgical versus non-surgical treatment.ResultsA total of 17,156 patients with closed calcaneus fractures were identified. Operative treatment was rendered in 7039 patients (41.03%). A multivariate logistic regression demonstrated multiple clinical and socio-demographic factors to significantly influence the utilization of surgical treatment including age, gender, insurance status, race/ethnicity, income, diabetes, peripheral vascular disease, psychosis, drug abuse, and alcohol abuse (p < 0.05). In addition, hospital size and hospital type (teaching versus non-teaching) showed a statistically significant difference (p < 0.05).ConclusionsBesides different clinical variables, we identified several socio-demographic factors influencing the utilization of surgical treatment of calcaneus fractures in the US patient population. Further studies need to identify the specific patient-related, provider-related, and system-related factors leading to these disparities.

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“…[1][2][3] Despite increasing utilization of total shoulder arthroplasty (TSA) as an effective management of various shoulder pathologies, [4][5][6] the literature has demonstrated that enduring racial and gender disparities exist in joint replacement procedures. [7][8][9][10][11][12][13][14][15] An 18-year analysis of Medicare part A data showed that in 1991, the use of primary total knee arthroplasty (TKA) was 36% lower for African-Americans compared with Caucasians. 1 Though utilization more than doubled for both African-Americans and Caucasians by 2008, the usage of primary TKA was still 40% lower for African-Americans.…”

Section: Introductionmentioning

confidence: 99%

Racial and Gender Shoulder Arthroplasty Utilization Disparities of High- and Low-Volume Centers in New York State

Markes

Pareek

Mesfin

et al. 2021

Journal of Shoulder and Elbow Arthroplasty

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Introduction The literature has consistently demonstrated utilization disparities in joint replacement procedures, though no studies have evaluated disparities in total shoulder arthroplasty with regard to operative volume. Methods We queried the New York (NY) Statewide Planning and Research Cooperative System (SPARCS) database for 32 410 total shoulder arthroplasties performed between 2009 and 2017. Patients were identified using Clinical Classifications Software code 154 for Non-Hip/Knee Arthroplasty and All Patient Refined-Diagnosis Related Group code 322 for Shoulder. Racial groups included Hispanic, non-Hispanic white, non-Hispanic black, and Other. High-volume centers were facilities that performed 2 standard deviations above the mean annual procedures. Utilization rates were calculated by dividing total shoulder arthroplasties per group by the 2010 NY Census population of that group. The Fisher exact test was used to determine significance. Results Total shoulder arthroplasty utilization increased from 43/100 000 to 73/100 000, two-thirds of which was driven by an increase in white resident utilization. More White residents per 100 000 underwent shoulder arthroplasty than Black, Hispanic, and Other residents per 100 000 residents of their respective race. White residents were 90% more likely than Hispanic residents to undergo total shoulder arthroplasty at high-volume centers ( P = .04). There were no differences in utilization rate regarding operative volume comparing Black or Other residents to White residents. More females underwent total shoulder arthroplasty than males, though there was no difference in utilization rate regarding operative volume. Conclusion Though total shoulder arthroplasty utilization nearly doubled, disparities persisted across gender and minority groups particularly in Hispanic utilization as White residents were 90% more likely than Hispanic residents to undergo shoulder arthroplasty at high-volume centers.

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Persisting Racial Disparities in Total Shoulder Arthroplasty Utilization and Outcomes

Abstract: We found increasing racial disparities in TSA utilization. Some disparities in outcomes exist as well. Patients, surgeons, and policy-makes should be aware of these findings and take action to reduce racial disparities.

Cited by 38 publications

References 43 publications

CORR Insights®: Racial Disparities in Above-knee Amputations after TKA: A National Database Study

CORR Insights®: Racial Disparities in Above-knee Amputations after TKA: A National Database Study

Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures

Racial and Gender Shoulder Arthroplasty Utilization Disparities of High- and Low-Volume Centers in New York State

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