Leslie R. M. Hausmann|Maria K. Mor|Barbara H. Hanusa|Susan Zickmund|Peter Z. Cohen|Richard E. Grant|Denise Kresevic|Howard S. Gordon|Bruce S. Ling|C. Kent Kwoh|Said A. Ibrahim
The Effect of Patient Race on Total Joint Replacement Recommendations and Utilization in the Orthopedic Setting
VA Pittsburgh Healthcare System|VA Pittsburgh Healthcare System|VA Pittsburgh Healthcare System|VA Pittsburgh Healthcare System|University of Pittsburgh|Louis Stokes Cleveland VA Medical Center|Louis Stokes Cleveland VA Medical Center|Jesse Brown VA Medical Center|University of Pittsburgh|University of Pittsburgh|Philadelphia VA Medical Center
extent treatment recommendations orthopedic setting contribute wellestablished racial disparities utilization total joint replacement tjr treatment advanced kneehip osteoarthritis explored examine whether orthopedic surgeons less likely recommend tjr africanamerican patients compared white patients similar clinical indications whether racial differences receipt tjr within six months study enrollment prospective observational study africanamerican aa n 120 white n 337 patients seeking treatment knee hip osteoarthritis veterans affairs orthopedic clinics patients completed surveys assessed sociodemographic clinical variables could influence osteoarthritis treatment orthopedic surgeons notes reviewed determine whether patients recommended tjr whether underwent procedure within 6 months study enrollment rate tjr recommendation 195 odds receiving tjr recommendation lower aa white patients similar age disease severity 046 95 ci 026083 p 001 however difference significant adjusting patient preference tjr 069 95 ci 036131 p 025 overall 103 patients underwent tjr within 6 months tjr less likely aa patients white patients similar age disease severity 041 95 ci 016105 p 006 difference reduced adjusting whether patients received recommendation procedure index visit 057 95 ci 021154 p 027 study race differences patient preferences tjr appeared underlie race differences tjr recommendations led race differences utilization procedure findings suggest patient treatment preferences play important role racial disparities tjr utilization orthopedic setting