Jasvinder A. Singh|Xin Lü|Gary E. Rosenthal|Said A. Ibrahim|Peter Cram
Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national medicare data
Mayo Clinic|University of Alabama at Birmingham|University of Iowa|University of Iowa|University of Pennsylvania|University of Iowa
examine whether racial disparities usage outcomes total knee total hip arthroplasty tka tha declined timewe used data us medicare program medpar data years 19912008 identify four separate cohorts patients primary tka revision tka primary tha revision tha cohort calculated standardised arthroplasty usage rates caucasian africanamerican medicare beneficiaries calendar year examined changes disparities time examined unadjusted adjusted outcomes 30day readmission rate discharge disposition etc caucasians africanamericans whether disparities decreased timein 1991 use primary tka 36 lower africanamericans compared caucasians 206 per 10000 africanamericans 321 per 10000 caucasians p00001 2008 usage primary tka 40 lower africanamericans 415 per 10000 africanamericans 688 per 10000 caucasians p00001 similar findings cohorts blackwhite disparities 30day hospital readmission increased significantly 19912008 among three patient cohorts example 1991 30day readmission rates africanamericans receiving primary tka 6 higher caucasians 2008 readmission rates africanamericans 24 higher p005 change disparity similarly blackwhite disparities proportion patients discharged home surgery increased across study period cohorts p005in 18year analysis us medicare data found little evidence declines racial disparities joint arthroplasty usage outcomes