Study Finds Racial Disparities in Hip Replacement Outcomes in Poorer Communities
A combination of race and socioeconomic factors plays a role in hip replacement outcomes, according to a study from the Hospital for Special Surgery (HSS) in New York.
The researchers found that black patients who lived in economically disadvantaged areas did worse in terms of physical function 2 years after surgery than white patients living in similar areas. In wealthier neighborhoods, no difference was seen in hip replacement outcomes between black and white patients.
The study was presented at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals in San Diego.
The researchers compared pain and function 2 years after surgery in black and white patients who were included in a total hip replacement registry of more than 4,000 patients. To measure community deprivation, they used the census tract variable “percent of the population with Medicaid insurance coverage.”
They evaluated pain and physical function using the Western Ontario and McMaster Universities Osteoarthritis Index, which asks questions about walking, using stairs, rising from a chair, getting out of bed, putting on socks, shopping, and other activities of daily living.
“Although we’re unable to pinpoint a specific reason for the study findings, perhaps the message for doctors is to try to identify patients at risk of a less favorable outcome and provide them with extra support,” said Susan M. Goodman, MD, a rheumatologist and director of the Integrative Rheumatology and Orthopedics Center of Excellence at HSS.
“Patients from impoverished areas also tend to have much worse pain and function at baseline, that is, when they first seek medical care,” she added. “Community-based outreach and education may be helpful to ensure that they have access to appropriate care before their situation deteriorates further.”
Goodman SM, Mehta BY, Zhang M, et al. Social Factors and Racial Disparities in Total Hip Arthroplasty Outcomes [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). Presented at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals, November 3-8, 2017, San Diego, California.