Worsening Arthroplasty Utilization With Widening Racial Variance During the COVID-19 Pandemic

Stronach, Benjamin M.; Zhang, Xiaoran; Haas, Derek A.; Iorio, Richard; Anoushiravani, Afshin A.; Barnes, C. Lowry

doi:10.1016/j.arth.2022.03.001

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Several reports and major news outlets have highlighted the glaring racial disparities exacerbated by the COVID-19 pandemic. 14 , 21 , 22 , 26 , 28 In a large cohort of patients within an integrated-delivery healthcare system, 77% of patients hospitalized with Covid-19 and 71% of those who died were Black despite the fact that Black patients comprised only 31% of the health-system population in the study. 22 These findings were corroborated in another study which showed that 34% of Covid deaths were among Black patients despite this group accounting for only 12% of the population in the United States.…”

Section: Discussionmentioning

confidence: 97%

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The impact of the COVID-19 pandemic on racial disparities in patients undergoing total shoulder arthroplasty in the United States

Fedorka¹,

Belniak²,

Haas³

et al. 2023

JSES International

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Section: Discussionmentioning

confidence: 97%

“…Worsening racial disparities during the COVID-19 pandemic have also been shown for Medicare patients undergoing hip and knee replacement surgery, with a 12.9% decreased likelihood of undergoing hip or knee replacement for non-White patients. 26 …”

mentioning

confidence: 99%

The impact of the COVID-19 pandemic on racial disparities in patients undergoing total shoulder arthroplasty in the United States

Fedorka¹,

Belniak²,

Haas³

et al. 2023

JSES International

Self Cite

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“…There is decreased surgical utilization in both inpatient and outpatient TJR for non-White patients 21,22 . The causes of racial disparity are multifactorial and can be attributed to socioeconomic factors, geographic and cultural differences, as well as discriminatory healthcare practices 21 . The downstream effect of healthcare reform and value-based incentive programs that limit access to TJA in patients with diabetes, obesity, and tobacco addiction disproportionately affect vulnerable patient populations who have higher incidence of these comorbid conditions 23 .…”

Section: Access To Care and Equity During Covid-19mentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on the Practice of Hip and Knee Arthroplasty

Sniderman,

Abdeen

2023

JBJS Reviews

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» The COVID-19 global pandemic resulted in unprecedented disruptions in care including massive surgical cancelations, a shift to outpatient surgery, and novel medical risks posed by COVID-19 infection on patients undergoing joint replacement surgery.» Refined patient optimization pathways have facilitated safe, efficient outpatient total joint arthroplasty in patient populations that may not otherwise have been considered eligible.» Rapid innovations emerged to deliver care while minimizing the risk of disease transmission which included the widespread adoption of telemedicine and virtual patient engagement platforms.» The widespread adoption of virtual technology was similarly expanded to resident education and continuing medical activities, which has improved our ability to propagate knowledge and increase access to educational initiatives.» Novel challenges borne of the pandemic include profound personnel shortages and supply chain disruptions that continue to plague efficiencies and quality of care in arthroplasty and require creative, sustainable solutions.

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“…Therefore it is not unexpected that orthopaedic hip and knee arthroplasty literature on volume projections have been cited extensively and applied broadly in the health-policy literature aiming to estimate future costs of total joint arthroplasties (TJA) [1][2][3][4][5][6] . Variation in demand and utilization of TJA may be subject to downturns due to extraordinary circumstances such as the COVID-19 pandemic 7,8 . Furthermore, geographical variation and racial disparities in TJA utilization have been documented across the United States 9,10 .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Variation in demand and utilization of TJA may be subject to downturns due to extraordinary circumstances such as the coronavirus disease 2019 (COVID-19) pandemic. 7,8 Furthermore, geographical variation and racial disparities in TJA utilization have been documented across the United States. 9,10 While drivers for utilization in THA and TKA are likely to remain multifactorial 11 and associated with year-to-year variability, previous national projections have provided a relatively reliable indicator of the expected progressive increase in demand for TJA.…”

mentioning

confidence: 99%

National Inpatient Datasets May No Longer Be Appropriate for Overall Total Hip and Knee Arthroplasties Projections after Removal from Inpatient-Only Lists

et al. 2023

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Introduction: It is unknown if the National Inpatient Sample (NIS) remains suitable to conduct projections for total knee (TKA) and hip arthroplasty (THA), after their removal from “Inpatient Only Lists” in 2018 and 2020, respectively. We aimed to: (1) quantify primary THA and TKA volume from 2008 to 2018; (2) project estimates of future volume of THA and TKA until 2050; (3) compare projections based on NIS data from 2008-to-2018 and 2008-to-2017, respectively. Methods: We identified all primary THA and TKAs performed from 2008-2018 from the NIS. The projected volume of THA and TKA were modeled using negative binomial regression models while incorporating log-transformed population data from the Centers for Disease Control and Prevention (CDC). Results: Annual volume increased by 26% for THA and 11% for TKA (2008/2018: THA:360,891/465,559; TKA:592,352/657,294). Based on 2008-to-2018 data, THA volume is projected to grow 120%, to 1,119,942 THAs by 2050. While, based on 2008-to-2017 data, THA volume is projected to grow 136%, to 1,219,852 THAs by 2050. Based on 2008-to-2018 data, TKA volume is projected to grow 4%, to 794,852 TKAs by 2050. While, based on 2008-to-2017 data, TKA volume is projected to grow 28%, to 1,037,474 TKAs by 2050. Discussion: Projections based on 2008-to-2017 data estimated up to 240,000 (23%) more annual TKAs by 2050, compared to projections based on 2008-to-2018 data. The largest discrepancy among THA projections was an 8.2% difference (99,000 THAs) for 2050. After 2018 for TKA, and potentially 2020 for THA, projections based on the NIS will have to be interpreted with caution and may only be appropriate to estimate future inpatient volume. Keywords: THA; TKA; surgical volume; nationwide utilization; outpatient shift Level of Evidence: Prognostic Level II

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Worsening Arthroplasty Utilization With Widening Racial Variance During the COVID-19 Pandemic

Cited by 8 publications

References 22 publications

The impact of the COVID-19 pandemic on racial disparities in patients undergoing total shoulder arthroplasty in the United States

The impact of the COVID-19 pandemic on racial disparities in patients undergoing total shoulder arthroplasty in the United States

The Impact of the COVID-19 Pandemic on the Practice of Hip and Knee Arthroplasty

National Inpatient Datasets May No Longer Be Appropriate for Overall Total Hip and Knee Arthroplasties Projections after Removal from Inpatient-Only Lists

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