Healthcare disparities : patients' perspectives on barriers to joint replacement

© 2023. The Author(s)..

OBJECTIVE: Racial and ethnic disparities in arthroplasty utilization are evident, but the reasons are not known. We aimed to identify concerns that may contribute to barriers to arthroplasty from the patient's perspective.

METHODS: We identified patients' concerns about arthroplasty by performing a mixed methods study. Themes identified during semi-structured interviews with Black and Hispanic patients with advanced symptomatic hip or knee arthritis were used to develop a questionnaire to quantify and prioritize their concerns. Multiple linear and logistic regression analyses were conducted to determine the association between race/ethnicity and the importance of each theme. Models were adjusted for sex, insurance, education, HOOS, JR/KOOS, JR, and discussion of joint replacement with a doctor.

RESULTS: Interviews with eight participants reached saturation and provided five themes used to develop a survey answered by 738 (24%) participants; 75.5% White, 10.3% Black, 8.7% Hispanic, 3.9% Asian/Other. Responses were significantly different between groups (p < 0.05). Themes identified were "Trust in the surgeon" "Recovery", "Cost/Insurance", "Surgical outcome", and "Personal suitability/timing". Compared to Whites, Blacks were two-fold, Hispanics four-fold more likely to rate "Trust in the surgeon" as very/extremely important. Blacks were almost three times and Hispanics over six times more likely to rate "Recovery" as very/extremely important.

CONCLUSION: We identified factors of importance to patients that may contribute to barriers to arthroplasty, with marked differences between Blacks, Hispanics, and Whites.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

BMC musculoskeletal disorders - 24(2023), 1 vom: 18. Dez., Seite 976

Sprache:

Englisch

Beteiligte Personen:

Goodman, Susan M [VerfasserIn]
Mannstadt, Insa [VerfasserIn]
Gibbons, J Alex B [VerfasserIn]
Rajan, Mangala [VerfasserIn]
Bass, Anne [VerfasserIn]
Russell, Linda [VerfasserIn]
Mehta, Bella [VerfasserIn]
Figgie, Mark [VerfasserIn]
Parks, Michael L [VerfasserIn]
Venkatachalam, Shilpa [VerfasserIn]
Nowell, W Benjamin [VerfasserIn]
Brantner, Collin [VerfasserIn]
Lui, Geyanne [VerfasserIn]
Card, Andrea [VerfasserIn]
Leung, Peggy [VerfasserIn]
Tischler, Henry [VerfasserIn]
Young, Sarah R [VerfasserIn]
Navarro-Millán, Iris [VerfasserIn]

Links:

Volltext

Themen:

Access to care
Arthroplasty
Journal Article
Mixed methods
Race/ethnicity
Surveys

Anmerkungen:

Date Completed 21.12.2023

Date Revised 20.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12891-023-07096-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366016059