Abstract

Access and outcomes disparities exist in hip and knee arthroplasty care. These disparities are associated with race, ethnicity, and social determinants of health such as income, housing, transportation, education, language, and health literacy. Additionally, medical co-morbidities affecting postoperative outcomes are more prevalent in under-resourced communities, which are more commonly communities of color. Navigating racial and ethnic differences in treating our hip and knee arthroplasty patients is necessary to reduce inequitable care. It is important to recognize our implicit biases and lessen their influence on our healthcare decision-making. Social determinants of health need to be addressed on a large scale, as the current inequitable system disproportionally impacts communities of color. Patients with lower health literacy have a higher risk of postoperative complications and poor outcomes after hip and knee replacement. Low health literacy can be addressed by improving communication, reducing barriers to care and supporting patients in their efforts to improve their own health. High-risk patients require more financial, physical and mental resources to care for them, and hospitals, surgeons and health insurance companies are often disincentivized to do so. By advocating for alternative payment models that adjust for the increased risk and take into account the increased perioperative work needed to care for these patients, surgeons can help reduce inequities in access to care. We have a responsibility to our patients to recognize and address social determinants of health, improve the diversity of our workforce, and advocate for improved access to care to decrease inequity and outcomes disparities in our field.

View details for DOI 10.1016/j.arth.2022.02.017

View details for PubMedID 35158005