Disparities in social determinants of health may prevent patients from receiving TJA
Key takeaways:
- Patients with OA who had difficulties with social determinants of health less likely underwent TJA.
- Difficulties with social determinants of health were an independent negative predictor for TJA.
SAN DIEGO — Patients with osteoarthritis who screened positive for difficulties with social determinants of health less likely to underwent total joint arthroplasty, according to results presented here.
“Screening is a potentially useful tool in identifying patients who may be lost to follow-up or that may not receive all the care that may be indicated,” Lucas Y. Kim, BS, a medical student at Yale School of Medicine, told Healio about results presented at American Academy of Orthopaedic Surgeons Annual Meeting.
Kim and colleagues retrospectively analyzed data from 5,917 adults with knee or hip OA who underwent social determinants of health screening from 2020 to 2023.
The social determinants of health in the screening assessment included financial strain, access to transportation, food insecurity, housing security and housing quality.
According to Kim, 1,122 patients screened positively for having difficulties with social determinants of health.
In addition, Kim said patients who screened positive for having difficulty in at least one social determinant of health were significantly less likely to undergo TJA vs. patients who did not report any difficulties with social determinants of health.
He added that having difficulties with social determinants of health was an independent risk factor for not having a TJA procedure, even after controlling for age, sex, race and ethnicity.
“As CMS and The Joint Commission are implementing their own measures of determining social determinants of health status in patients, there will be a much greater availability of [social determinants of health] screening available for all patients,” Kim said. “This will identify patients with OA who are less likely to have TJA, creating an opportunity to intervene and provide interventions and support to such high-risk patients.”
He added, “This will hopefully create steps toward an ideal future where TJA will be available for all patients that it is indicated for.”
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Kim LY, et al. Paper 369. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.