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Racial Differences Seen for Joint Replacement Care and Outcomes

Differences seen across the continuum of care for knee, hip total joint arthroplasty for osteoarthritis

FRIDAY, April 29, 2022 (HealthDay News) — Racial differences persist across the continuum of care among patients undergoing total joint arthroplasty (TJA), according to a study published in the April 15 issue of the Journal of Bone and Joint Surgery.

Jeffrey Okewunmi, from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues assessed trends in racial differences in care and outcome characteristics before, during, and after TJA surgery for osteoarthritis. The analysis used Medicare claims data to identify 1.48 million TJAs (2013 to 2018).

The researchers found that in both 2013 and 2018, Black patients (5.0 percent) were more likely than White patients to have a higher Deyo-Charlson comorbidity index (score >0; odds ratio [OR], 1.32 for both), to require more transfusions (OR, 1.55 and 1.77), to be discharged to institutional post-acute care (OR, 1.40 and 1.49), and to be readmitted within 90 days (OR, 1.38 and 1.21). The Comprehensive Care for Joint Replacement program coincided with reductions in racial differences in 90-day readmission (−1.24 percent) and 180-day readmission (−1.28 percent) in adjusted difference-in-differences analyses.

“These findings both highlight the extent and persistence of racial differences in this surgical patient population while also emphasizing the potential for a novel approach to reduce racial disparities: bundled payment designs,” the authors write.

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