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dc.contributor.authorCavanaugh, A. M.
dc.contributor.authorRauh, M. J.
dc.contributor.authorThompson, C. A.
dc.contributor.authorAlcaraz, J.
dc.contributor.authorMihalko, W. M.
dc.contributor.authorBird, C. E.
dc.contributor.authorEaton, C. B.
dc.contributor.authorRosal, Milagros C
dc.contributor.authorLi, Wenjun
dc.contributor.authorShadyab, A. H.
dc.contributor.authorGilmer, T.
dc.contributor.authorLaCroix, A. Z.
dc.date2022-08-11T08:10:19.000
dc.date.accessioned2022-08-23T17:04:01Z
dc.date.available2022-08-23T17:04:01Z
dc.date.issued2019-08-09
dc.date.submitted2019-09-23
dc.identifier.citation<p>Osteoarthritis Cartilage. 2019 Aug 9. pii: S1063-4584(19)31153-7. doi: 10.1016/j.joca.2019.07.015. [Epub ahead of print] <a href="https://doi.org/10.1016/j.joca.2019.07.015">Link to article on publisher's site</a></p>
dc.identifier.issn1063-4584 (Linking)
dc.identifier.doi10.1016/j.joca.2019.07.015
dc.identifier.pmid31404657
dc.identifier.urihttp://hdl.handle.net/20.500.14038/44551
dc.description.abstractOBJECTIVE: To evaluate racial and ethnic disparities in utilization of total knee arthroplasty (TKA) in relation to demographic, health, and socioeconomic status variables. DESIGN: Prospective study of 102,767 Women's Health Initiative postmenopausal women initially aged 50-79, examining utilization rates of primary TKA between non-Hispanic Black/African American, non-Hispanic White, and Hispanic/Latina women (hereafter referred to as Black, White, and Hispanic). A total of 8,942 Black, 3,405 Hispanic, and 90,420 White women with linked Medicare claims data were followed until time of TKA, death, or transition from fee-for-service coverage. Absolute disparities were determined using utilization rates by racial/ethnic group and relative disparities quantified using multivariable hazards models in adjusting for age, arthritis, joint pain, mobility disability, body mass index, number of comorbidities, income, education, neighborhood socioeconomic status (SES), and geographic region. RESULTS: TKA utilization was higher among White women (10.7/1,000 person-years) compared to Black (8.5/1,000 person-years) and Hispanic women (7.6/1,000 person-years). Among women with health indicators for TKA including diagnosis of arthritis, moderate to severe joint pain, and mobility disability, Black and Hispanic women were significantly less likely to undergo TKA after adjusting for age [Black: HR (95% confidence interval) = 0.70 (0.63-0.79); Hispanic: HR = 0.58 (0.44-0.77)]. Adjustment for SES modestly attenuated the measured disparity, but significant differences remained [Black: HR = 0.75 (0.67-0.89); Hispanic: HR = 0.65 (0.47-0.89)]. CONCLUSIONS: Compared to White women, Black and Hispanic women were significantly less likely to undergo TKA after considering need and appropriateness for TKA and SES. Further investigation into personal-level and provider-level factors that may explain these disparities is warranted.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=31404657&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.joca.2019.07.015
dc.subjectAfrican American
dc.subjectArthritis
dc.subjectHispanic
dc.subjectJoint replacement
dc.subjectMedicare
dc.subjectBehavioral Medicine
dc.subjectCommunity Health and Preventive Medicine
dc.subjectHealth Services Administration
dc.subjectOrthopedics
dc.subjectPreventive Medicine
dc.subjectRace and Ethnicity
dc.subjectSurgical Procedures, Operative
dc.subjectWomen's Health
dc.titleRacial and ethnic disparities in utilization of total knee arthroplasty among older women
dc.typeJournal Article
dc.source.journaltitleOsteoarthritis and cartilage
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/prc_pubs/145
dc.identifier.contextkey15399970
html.description.abstract<p>OBJECTIVE: To evaluate racial and ethnic disparities in utilization of total knee arthroplasty (TKA) in relation to demographic, health, and socioeconomic status variables.</p> <p>DESIGN: Prospective study of 102,767 Women's Health Initiative postmenopausal women initially aged 50-79, examining utilization rates of primary TKA between non-Hispanic Black/African American, non-Hispanic White, and Hispanic/Latina women (hereafter referred to as Black, White, and Hispanic). A total of 8,942 Black, 3,405 Hispanic, and 90,420 White women with linked Medicare claims data were followed until time of TKA, death, or transition from fee-for-service coverage. Absolute disparities were determined using utilization rates by racial/ethnic group and relative disparities quantified using multivariable hazards models in adjusting for age, arthritis, joint pain, mobility disability, body mass index, number of comorbidities, income, education, neighborhood socioeconomic status (SES), and geographic region.</p> <p>RESULTS: TKA utilization was higher among White women (10.7/1,000 person-years) compared to Black (8.5/1,000 person-years) and Hispanic women (7.6/1,000 person-years). Among women with health indicators for TKA including diagnosis of arthritis, moderate to severe joint pain, and mobility disability, Black and Hispanic women were significantly less likely to undergo TKA after adjusting for age [Black: HR (95% confidence interval) = 0.70 (0.63-0.79); Hispanic: HR = 0.58 (0.44-0.77)]. Adjustment for SES modestly attenuated the measured disparity, but significant differences remained [Black: HR = 0.75 (0.67-0.89); Hispanic: HR = 0.65 (0.47-0.89)].</p> <p>CONCLUSIONS: Compared to White women, Black and Hispanic women were significantly less likely to undergo TKA after considering need and appropriateness for TKA and SES. Further investigation into personal-level and provider-level factors that may explain these disparities is warranted.</p>
dc.identifier.submissionpathprc_pubs/145
dc.contributor.departmentPrevention Research Center
dc.contributor.departmentDepartment of Population and Quantitative Sciences, Division of Preventive and Behavioral Medicine
dc.contributor.departmentDepartment of Medicine


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