Beyond Discharge Disposition: A Scoping Review on Sociodemographic Disparities in Rehabilitation Use After Hip and Knee Arthroplasty.

IF 3.5 4区医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-10-02 DOI:10.1093/ptj/pzae074

Allyn Bove, Bayan Aldhahwani, Rose Turner, Sean Repage, Parker Denny, Cynthia Brand, Kaitlyn Sweeney, Sam Allison, Heather Ross, Kelli D Allen, Jared W Magnani, Lauren Terhorst, Anthony Delitto, Janet Freburger

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Abstract

Objective: The aims of this scoping review were to summarize the evidence regarding sex, racial, ethnic, geographic, and socioeconomic disparities in post-acute rehabilitation following total hip arthroplasty (THA) and knee arthroplasty (TKA).

Methods: Literature searches were conducted in Ovid MEDLINE, EMBASE, CINAHL, Web of Science, and PEDro. Studies were included if they were original research articles published 1993 or later; used data from the US; included patients after THA and/or TKA; presented results according to relevant sociodemographic variables, including sex, race, ethnicity, geography, or socioeconomic status; and studied the utilization of post-acute rehabilitation as an outcome.

Results: Twelve studies met the inclusion criteria. Five examined disparities in inpatient rehabilitation and found that Black patients and women experience longer lengths of stay after arthroplasty, and women are less likely than men to be discharged home after inpatient THA rehabilitation. Four studies examined data from skilled nursing facilities and found that insurance type and dual eligibility impact length of stay and rates of community discharge but found conflicting results regarding racial disparities in skilled nursing facility utilization after TKA. Five studies examined home health data and noted that rural agencies provide less care after TKA. Results regarding racial disparities in home health utilization after arthroplasty were conflicting. Six studies of outpatient rehabilitation noted geographic differences in timing of outpatient rehabilitation but mixed results regarding race differences in outpatient rehabilitation.

Conclusion: Current evidence indicates that sex, race, ethnicity, geography, and socioeconomic status are associated with disparities in postacute rehabilitation use after arthroplasty.

Impact: Rehabilitation providers across the postacute continuum should be aware of disparities in the population of patients after arthroplasty and regularly assess social determinants of health and other factors that may contribute to disparities. Customized care plans should ensure optimal timing and amount of rehabilitation is provided, and advocate for patients who need additional care to achieve the desired functional outcome.

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超越出院处置：关于髋关节和膝关节置换术后康复治疗使用方面社会人口差异的范围界定综述》（A Scoping Review on Sociodemographic Disparities in Rehabilitation Use after Hip and Knee Arthroplasty）。

目的本范围综述旨在总结有关全髋关节置换术（THA）和膝关节置换术（TKA）术后康复的性别、种族、民族、地域和社会经济差异的证据：在 Ovid MEDLINE、EMBASE、CINAHL、Web of Science 和 PEDro 中进行文献检索。纳入的研究必须是1993年或之后发表的原创研究文章；使用的数据来自美国；纳入了THA和/或TKA术后患者；根据相关社会人口变量（包括性别、种族、民族、地域或社会经济状况）展示了研究结果；并将急性期后康复的使用情况作为研究结果之一：结果：12 项研究符合纳入标准。其中五项研究调查了住院康复治疗中的差异，发现黑人患者和女性患者在关节置换术后住院时间更长，而且女性在THA住院康复治疗后出院回家的可能性低于男性。四项研究检查了专业护理机构的数据，发现保险类型和双重资格对住院时间和社区出院率有影响，但在 TKA 术后专业护理机构利用率的种族差异方面发现了相互矛盾的结果。五项研究检查了家庭医疗数据，并指出农村机构在 TKA 术后提供的护理较少。关于关节置换术后家庭医疗利用率的种族差异，研究结果相互矛盾。六项关于门诊康复的研究指出了门诊康复时间的地域差异，但关于门诊康复的种族差异的结果不一：目前的证据表明，性别、种族、民族、地域和社会经济地位与关节置换术后急性期康复使用的差异有关：影响：整个急性期后康复服务的提供者都应意识到关节置换术后患者群体中存在的差异，并定期评估健康的社会决定因素和其他可能导致差异的因素。定制的护理计划应确保提供最佳的康复时间和康复量，并为需要额外护理的患者提供支持，以达到预期的功能效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.