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Study using VA system showed racial differences for total knee arthroplasty rates
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Among patients diagnosed with osteoarthritis in the Department of Veterans Affairs health care system, racial disparities persist in the rates of total knee arthroplasty, according to recent findings.
Researchers collected data on total knee arthroplasty (TKA) procedures documented in the Veterans Affairs (VA) Musculoskeletal Disorders cohort and focused on veterans who enrolled in the cohort with osteoarthritis (OA) between 2001 and 2011. Eligible participants were at least 50 years old with any OA diagnosis recorded during at least two outpatient visits within 18 months of each other or at least one inpatient stay within the study interval. Those who met these criteria were counted once and monitored from their OA index date. Among these patients, those without missing racial/ethnic information were classified into three mutually exclusive groups: non-Hispanic white (ie, whites, n = 473,170); non-Hispanic black (ie, black, n = 50,172) and Hispanic ethnicity (n = 16,499).
Researchers identified 12,087 TKA procedures performed within a median follow-up interval of 8 years, with an overall rate of 2.2%. A model assessing racial and ethnic differences by year and adjusted for age, sex, BMI and pain intensity revealed black patients were less likely than whites to undergo TKA in all but 2 years of the observation interval. There were no significant differences in likelihood of undergoing TKA between Hispanic patients and white patients during any of the years analyzed.
this was significantly lower in those with PTSD. Conversely, the likelihood of undergoing TKA increased in relationship to increased BMI and pain intensity.
TKA procedures were performed for an overall rate of 8.1%. In this analysis, trends similar to those seen in the full analytic sample were observed in terms of racial and ethnic disparity; black patients were less likely than white patients to undergo TKA in all but 2 years of observation. Again, no significant differences were observed in TKA rates between Hispanic patients and white patients.
“In the VA health care system, black veterans diagnosed with OA in most years from 2001 to 2011 were less likely to undergo TKA than white veterans by 2013, after adjusting for demographic and key clinical characteristics,” the researchers wrote. “To ensure that the health care needs of all veterans are being meet, it is important to continue efforts to understand and develop interventions to reduce racial differences in TKA in veterans.” – by Jennifer Byrne
Disclosures: The authors report no relevant financial disclosures.
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