Reductions in Race and Ethnic Disparities in Hospital Readmissions Following Total Joint Arthroplasty from 2005 to 2015

• DOI: 10.2106/jbjs.18.01112
• Publication Date: 2019-10-09T18:31:42Z
• Authors: Robert H. Aseltine; Wenjie Wang; Ross A. Benthien; Matthew Katz; Catherine Wagner; Jun Yan; Courtland G. Lewis
• Keywords: Current Procedural Terminology; Joint arthroplasty; Odds; Diagnosis code

Background: Racial and ethnic disparities in hospital readmissions following total joint arthroplasty present opportunities for reducing cost improving health equity. Despite efforts to reduce the general population, no studies have documented impact of these on racial readmissions. The purpose this study was determine whether comprehensive impacted readmission rates during period from 2005 2015. Methods: We conducted a retrospective analysis comparing patients readmitted not within 30 days by estimating logistic regression models clustered data using generalized equations (GEEs) R. Connecticut discharge admitted International Classification Diseases, Ninth Revision (ICD-9) procedure codes 81.51 81.54 (Current Procedural Terminology [CPT] 27130 27447) 2015 U.S. Centers Medicare & Medicaid Services (CMS) fiscal years were analyzed. Models included quadratic terms capture nonlinear time trends readmissions, as well statistical interaction between race or ethnicity both linear predicting odds readmission. Results: There 102,510 admissions hospitals 30-day (all-cause) rate declined 5.1% 3.6% 2015, with steeper downward trend observed 2009 results indicated that black (odds ratio [OR], 1.68; p < 0.0001) Hispanic (OR, 1.48; significantly more likely be than white over period. significant capturing increased compared those through 2008 decreased relative 0.24; = 0.030). Conclusions: Data show 1.5 percentage points decline much pronounced among patients, resulting narrowing surgical procedure. Clinical Relevance: minorities historically been at risk complications hospital-based care. This reveals such are remediable should foster further research primary drivers remedies disparities.