Sep 18, 2013 - registries from Denmark, Sweden and Norway.4 In the USA, 670 000 TKA ... in racial disparities for joint arthroplasty presents a challenge and ...
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ARD Online First, published on September 18, 2013 as 10.1136/annrheumdis-2013-203494 Clinical and epidemiological research
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Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national medicare data Jasvinder A Singh,1,2 Xin Lu,3,4 Gary E Rosenthal,3,4 Said Ibrahim,5 Peter Cram3,4 Handling editor Tore K Kvien ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ annrheumdis-2013-203494). 1
Birmingham Veterans Affairs Medical Center, AL and the Departments of Medicine and Epidemiology, Medicine Service, University of Alabama at Birmingham, Birmingham, Alabama, USA 2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA 3 Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA 4 CADRE, Iowa City Veterans Administration Medical Center, Iowa City, Iowa, USA 5 Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and the Perelman University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
Received 19 February 2013 Revised 26 June 2013 Accepted 15 July 2013
ABSTRACT Objective To examine whether racial disparities in usage and outcomes of total knee and total hip arthroplasty (TKA and THA) have declined over time. Methods We used data from the US Medicare Program (MedPAR data) for years 1991–2008 to identify four separate cohorts of patients ( primary TKA, revision TKA, primary THA, revision THA). For each cohort, we calculated standardised arthroplasty usage rates for Caucasian and African–American Medicare beneficiaries for each calendar year, and examined changes in disparities over time. We examined unadjusted and adjusted outcomes (30-day readmission rate, discharge disposition etc.) for Caucasians and African–Americans, and whether disparities decreased over time. Results In 1991, the use of primary TKA was 36% lower for African–Americans compared with Caucasians (20.6 per 10 000 for African–Americans; 32.1 per 10 000 for Caucasians; p
