Disparities in Total Knee and Total Hip Arthroplasty Rates in the Population of Alaska, 2015 to 2018

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-06-26 DOI:10.1002/acr.25394
Elizabeth D. Ferucci, Peter Holck
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Abstract

Objective

Racial and ethnic disparities in total joint replacements have been documented. Our objective was to determine the rates of total joint replacements for Alaska Native/American Indian (AN/AI) individuals compared with non-AN/AI individuals in Alaska and investigate the differences in characteristics and outcomes by race.

Methods

We used hospital discharge data from the Alaska Health Facilities Data Reporting Program from 2015 to 2018. We identified people with an inpatient primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA). We determined the population proportion of each procedure, age-adjusted rates by race, age-specific rates, and multivariable adjusted rate ratios for TKA or THA. We compared the characteristics of people undergoing primary TKA and THA by race.

Results

In 2,195,806 person-years, there were 8,131 arthroplasty procedures (4,594 primary TKAs, 2,791 primary THAs, 378 revision TKAs, and 368 revision THAs). Primary TKAs and THAs were less likely in people of AN/AI or “Other” race compared with people of White race, with some heterogeneity in the “Other” race category. In multivariable models, the adjusted rate ratio for AN/AI compared with White race for TKA was 0.70 (95% confidence interval [CI] 0.60–0.82) and for THA was 0.69 (95% CI 0.55–0.85). AN/AI individuals undergoing TKA and THA were more likely to reside in rural locations, be younger than 65 years, have longer hospital stay, and discharge to home.

Conclusion

This study confirmed the existence of racial disparities in TKA and THA in Alaska. There may be many underlying causes, and future research should focus on improving access to care.

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2015-2018 年阿拉斯加州人口全膝关节和全髋关节置换术率的差异。
目的:全关节置换术中的种族和民族差异已被记录在案。我们的目标是确定阿拉斯加原住民/美洲印第安人(AN/AI)与非阿拉斯加原住民/美洲印第安人相比的全关节置换率,并调查不同种族在特征和结果方面的差异:我们使用了 2015-2018 年阿拉斯加卫生设施数据报告计划的出院数据。我们确定了接受住院初级或翻修全膝关节置换术(TKA)或全髋关节置换术(THA)的患者。我们确定了每种手术的人口比例、按种族划分的年龄调整率、年龄特定率以及 TKA 或 THA 的多变量调整率比。我们按种族比较了接受初级 TKA 和 THA 手术者的特征:在 219.5806 万人年中,共进行了 8131 例关节成形术(4594 例初次 TKA、2791 例初次 THA、378 例翻修 TKA、368 例翻修 THA)。与白种人相比,AN/AI 或其他种族的人接受初次 TKA 和 THA 的可能性较低,其他种族类别中存在一些异质性。在多变量模型中,与白种人相比,AN/AI 的 TKA 调整率比为 0.70(95% 置信区间 (CI) 0.60-0.82),THA 调整率比为 0.69(95% CI 0.55-0.85)。接受TKA和THA手术的AN/AI患者更有可能居住在农村地区、年龄小于65岁、住院时间更长以及出院回家:本研究证实,阿拉斯加州的 TKA 和 THA 存在种族差异。可能有许多潜在的原因,未来的研究应侧重于改善医疗服务的可及性。
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
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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